DESIGNATED SUPPORTIVE LIVING RESIDENT EXPERIENCE SURVEY REPORT Provincial Results September 2020 The Health Quality Council of Alberta is a provincial agency that pursues opportunities to improve patient safety and health service quality for Albertans. It surveys Albertans on their experience with patient safety and health service quality, gathers and analyzes information, monitors the healthcare system, and collaborates with Alberta Health, Alberta Health Services, health professions, academia, and other stakeholders to drive actionable improvements. Our responsibilities are set forth in the Health Quality Council of Alberta Act.

DOCUMENT COPYRIGHT The Health Quality Council of Alberta holds copyright and intellectual property rights of this document. This document is licensed under a Creative Commons “Attribution-Non-Commercial-No Derivatives 4.0 International” license: http://creativecommons.org/licenses/by-nc-nd/4.0/

You may copy, distribute, or transmit only unaltered copies of the document, and only for non- commercial purposes. Attribution is required if content from this document is used as a resource or reference in another work that is created. To reference this document, please use the following citation: Health Quality Council of Alberta. Designated Supportive Living Resident Experience Survey Report. Provincial results. Calgary, Alberta, Canada: Health Quality Council of Alberta; September 2020. Please contact the Health Quality Council of Alberta for more information: [email protected], 403.297.8162. TABLE OF CONTENTS

1.0 USING THE RESULTS AND OVERVIEW OF FINDINGS ...... 5

1.1 A note on how to use the results ...... 5 1.2 2019 Site results at a glance ...... 5 1.3 What are the actions for improvement? ...... 15

2.0 BACKGROUND ...... 18

2.1 Designated Supportive Living ...... 18 2.2 HQCA’s Designated Supportive Living Resident Experience Survey ...... 21 2.3 HQCA’s Designated Supportive Living Family Experience Survey ...... 21

3.0 SURVEY PROCESS AND METHODOLOGY ...... 22

3.1 The survey instrument ...... 22 3.2 Survey sampling ...... 22 3.3 Survey protocol and survey type ...... 22 3.4 Quantitative analytical approach ...... 23

4.0 2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS ...... 25

4.1 Overall Care Rating ...... 25 4.2 Propensity to Recommend ...... 26 4.3 Dimension of Care: Facility Environment ...... 27 4.4 Dimension of Care: Resident Environment ...... 29 4.5 Dimension of Care: Choice ...... 31 4.6 Dimension of Care: Relationship with Employees ...... 33 4.7 Dimension of Care: Activities ...... 35 4.8 Dimension of Care: Meals and Dining ...... 37 4.9 Dimension of Care: Communications ...... 39 4.10 Dimension of Care: Care and Services ...... 41 4.11 Dimension of Care: Employee Responsiveness ...... 43 4.12 Dimension of Care: Laundry ...... 45 4.13 Dimension of Care: General Satisfaction ...... 47 4.14 Additional Care Questions ...... 49

5.0 SITE CHARACTERISTICS ...... 53

5.1 Level of care ...... 53 5.2 Site size: Number of DSL spaces ...... 54 5.3 Operator type ...... 55 5.4 Site age ...... 55 5.5 Geography: Urban versus rural ...... 56

6.0 LIMITATIONS ...... 57

7.0 APPENDICES ...... 58

APPENDIX I: RESIDENT EXPERIENCE SURVEY TOOL (PAPER VERSION) ...... 59

APPENDIX II: SURVEY PROCESS AND METHODOLOGY ...... 68

APPENDIX III: SURVEY MODALITY ...... 80

APPENDIX IV: DIFFERENCES BETWEEN 2019 SURVEY AND 2016 SURVEY ...... 81

APPENDIX V: CRITERIA FOR SITE INCLUSION 2019 ...... 82

APPENDIX VI: 2019 RESPONDENT CHARACTERISTICS ...... 88

APPENDIX VII: 2019 SITE RESULTS ...... 90

APPENDIX VIII: SUMMARY OF 2019 PROVINCIAL AND ZONE-LEVEL RESPONSES TO INDIVIDUAL SURVEY QUESTIONS ...... 155

APPENDIX IX: MODELLING SPECIFICS...... 175

APPENDIX X: DETERMINING ACTIONS FOR IMPROVEMENT ...... 176

1.0 USING THE RESULTS AND OVERVIEW OF FINDINGS

1.1 A note on how to use the results The focus of this report is to describe the current state of designated supportive living (DSL) from the perspective of the residents who live at DSL sites. The results for each DSL site are compared amongst site peers within each AHS Zone, in addition to the previous survey iteration. Ultimately, these results are intended to guide reflection on performance and assist in identifying quality improvement opportunities. The key measures used to present the survey results include 11 Dimensions of Care, the Overall Care Rating (a measure of residents’ overall experience), and the Propensity to Recommend. The Dimensions of Care each represent a set of questions that share a similar theme; they influence the Overall Care Rating and can be used to identify areas of success and opportunities for improvement at DSL sites across Alberta. Other factors can contribute to residents’ experience at a site. Resident experience alone should not be used to assess site performance in the absence of other information, such as site demographics (i.e., average age of residents and percentage male/female), level-of-need of the resident population, and other quality measures such as those derived from the interRAITM Resident Assessment Instrument (RAI), complaints and concerns, accreditation results, and compliance with Continuing Care Health Service Standards (CCHSS). One option for publicly available information is the HQCA’s FOCUS on Healthcare website. It was expanded to include designated supportive living in 2019. It features 28 interactive charts that present administrative data as well as patient experience survey data about designated supportive living. Users can compare information about designated supportive living sites or zones, and look at data presented over time. https://focus.hqca.ca/designated-supportive-living/ This report provides a single perspective of several possible interpretations of these findings. DSL owners, operators, and other stakeholders may choose to examine and interpret the findings differently. While being mindful of the limitations of the data, there are a number of ways to interpret and use the results. It is important to note that while significance testing can identify where there has been a mathematical change, this does not necessarily indicate a change in performance especially when comparing two survey cycles. In addition, results that did not show any statistically significant change or difference may still be important.

1.2 2019 Site results at a glance Among sites that did Table 1 below provides a summary of 2019 site-level results. Sites are show a statistically grouped by AHS Zone and rank-ordered by performance on significant change in Dimensions of Care scores only. These measures were selected because any of the key they reflect specific aspects of care that sites have the opportunity to measures, the majority directly impact as opposed to measures that reflect general overall of these changes were experience (i.e., Overall Care Rating and Propensity to Recommend). in the negative direction.

USING THE RESULTS AND OVERVIEW OF FINDINGS 5

To provide context, other variables were included such as geography, site size (number of DSL spaces), number of respondents, level of care (DSL3, DSL4, or both), and operator type (AHS, Private, Not-for- Profit). The majority of sites did not show a statistically significant change in any of the key measures, defined as the Dimensions of Care, Propensity to Recommend, and Overall Care Rating from the previous survey conducted in 2016. Among the sites that did show a statistically significant change in any of the key measures, the majority of those changes were in the negative direction. How sites were rank ordered: 1. For each site, a rank was calculated for six of the eleven Dimensions of Care found to have a statistically significant influence on the Overall Care Rating, resulting in six separate ranks:

a) Facility Environment b) Resident Environment c) Choice d) Relationship with Employees e) Activities f) Meals and Dining 2. For each site, each rank was then weighted by how strongly the Dimension of Care influenced the Overall Care Rating (if a Dimension of Care had a stronger association with the Overall Care Rating it was weighted more heavily).

3. Next, based on the weighted ranks above, a “weighted average” rank was computed. 4. Within each AHS zone, sites were then rank ordered based on this weighted average rank. Sites that consistently have positive scores across the Dimensions of Care will in turn have a high rank. Additional details about this approach can be found in Appendix II. While only 2019 data is presented in Table 1 below, statistical tests were conducted to test significant differences across survey cycles (2019 versus 2016).

. When the 2019 site score is shaded GREEN this indicates that the 2019 score is significantly HIGHER than the 2016 score.

. When the 2019 site score is shaded ORANGE this indicates that the 2019 score is significantly LOWER than the 2016 score. It is important to note that site rankings from year to year are not entirely comparable as site participation and eligibility for public reporting varies across survey years. In addition, while significance testing can identify where there has been a mathematical change, this does not necessarily indicate a change in operational practices (i.e., performance) especially when comparing only two survey cycles.

USING THE RESULTS AND OVERVIEW OF FINDINGS 6

Table 1: Summary of 2019 site results

Dimensions of Care

type

North Zone

Order (N = 17 sites) Choice Facility Facility Geography General General Laundry DSL4, Both) Resident Resident Activities Employee Propensity to Operator Operator Employees Satisfaction Environment Environment Recommend (%) Respondents (N) Meals & Dining & Meals Communication responsiveness Overall Care Rating Care Overall Level Care of (DSL3, Relationship with Care and Services and Care Number of DSL Spaces 1 Heimstaed Lodge 97 98 98 99 98 90 93 98 97 100 96 9.2 100 Rural 54 6 Both NP 2 Manoir du Lac 94 96 97 97 89 88 97 89 97 100 89 7.1 83 Rural 35 12 Both Priv 3 Vilna Lodge 96 96 95 92 89 91 96 92 94 98 100 8.4 100 Rural 12 10 DSL3 NP 4 Shepherd's Care Barrhead 91 96 96 97 82 90 90 84 89 93 86 8.0 93 Rural 42 14 DSL4 NP 5 Stone Brook 93 95 95 97 85 84 95 95 92 95 91 8.4 100 Rural 56 14 Both NP 6 Smithfield Lodge 91 95 88 94 84 80 91 89 90 91 88 8.2 100 Rural 46 12 Both AHS 7 Whispering Pines Seniors Lodge 96 92 94 80 83 87 87 90 79 100 75 7.6 80 Rural 15 5 DSL4 NP 8 Mackenzie Place Supportive Living 91 90 91 92 76 71 92 89 85 92 79 7.7 82 Urban 71 31 DSL4 AHS 9 Points West Living Slave Lake 90 90 93 89 81 82 86 86 88 97 90 8.5 100 Rural 45 6 DSL4 Priv 10 Grande Prairie Care Centre 90 91 88 87 73 74 83 82 79 96 81 8.3 93 Urban 60 15 DSL4 Priv 11 Points West Living Cold Lake 85 92 90 91 64 68 82 82 80 86 71 7.2 83 Rural 42 6 Both Priv 12 Prairie Lake Seniors Community 88 89 88 91 77 82 85 82 83 95 79 7.6 90 Urban 95 21 DSL4 Priv Emerald Gardens Retirement 13 85 89 90 88 77 80 84 79 83 97 81 7.4 88 Urban 15 10 DSL3 Priv Residence 14 Points West Living Peace River 88 83 91 93 70 70 89 84 84 92 80 7.1 90 Rural 42 10 Both Priv 15 J.B. Wood Continuing Care Centre 84 94 85 84 49 57 84 82 77 85 64 6.3 60 Rural 40 7 DSL4 AHS 16 Edson Healthcare Centre 90 81 82 84 71 78 84 76 77 75 65 6.8 80 Rural 38 6 DSL4 AHS 17 Hinton Continuing Care Centre 82 83 88 83 70 76 80 81 83 83 81 6.7 90 Rural 52 11 DSL4 AHS

USING THE RESULTS AND OVERVIEW OF FINDINGS 7

Table 1: Summary of 2019 site results (continued)

Dimensions of Care

Edmonton Zone Order

(N = 36 sites) Spaces Choice Facility Facility Geography General General Laundry DSL4, Both) Services Resident Resident Care and Activities Employee Propensity to Operator type Operator Employees Satisfaction Number of DSL Environment Environment Recommend (%) Respondents (N) Meals & Dining & Meals Communication responsiveness Overall Care Rating Care Overall Level Care of (DSL3, Relationship with Good Samaritan Society George 1 95 95 95 94 84 87 90 73 97 89 89 8.5 89 Urban 30 20 DSL4 NP Hennig Place Chartwell Wild Rose Retirement 2 95 95 93 92 88 83 79 91 91 100 100 7.5 100 Urban 27 5 DSL4 Priv Residence 3 Our Parents' Home 97 97 96 95 72 82 67 71 88 89 90 8.6 100 Urban 50 5 DSL4 Priv 4 Shepherd's Garden 93 98 95 94 79 82 91 91 92 96 91 8.5 94 Urban 45 17 DSL4 NP Good Samaritan Society Spruce 5 94 93 91 92 86 96 93 87 95 95 89 8.3 91 Urban 30 13 DSL4 NP Grove Centre 6 Citadel Mews West 94 92 91 96 87 78 87 80 89 95 88 7.9 90 Urban 67 33 DSL4 Priv 7 Shepherd's Care Vanguard 93 94 96 95 82 73 88 86 82 96 83 7.1 80 Urban 92 10 DSL4 NP 8 Riverbend Retirement Residence 95 91 94 91 84 79 87 79 88 94 88 7.2 100 Urban 38 11 DSL4 Priv 9 Glastonbury Village (Mews) 92 94 90 91 86 78 93 86 89 93 93 8.2 95 Urban 49 21 DSL4 Priv 10 St. Albert Retirement Residence 93 89 91 94 88 79 91 85 85 95 88 7.8 90 Urban 92 11 DSL4 Priv 11 Lifestyle Options Whitemud 89 92 97 95 81 79 95 75 86 95 94 8.4 100 Urban 80 12 DSL4 NP Chartwell Country Cottage Retirement 12 96 90 88 87 87 87 96 80 86 94 89 8.1 100 Urban 26 11 DSL4 Priv Residence 13 Tuoi Hac - Golden Age Manor 94 93 89 86 82 76 88 83 85 93 90 8.2 100 Urban 91 28 DSL4 NP 14 Emmanuel Home 91 87 95 91 89 86 93 85 83 90 88 8.6 83 Urban 15 6 DSL4 NP 15 Laurel Heights Retirement Residence 92 94 89 89 82 77 87 84 84 89 84 7.7 100 Urban 70 34 DSL4 Priv 16 Shepherds Care Kensington 94 92 88 89 83 73 83 71 89 94 87 7.0 86 Urban 86 22 DSL4 NP 17 CapitalCare Laurier House Strathcona 92 94 87 90 81 76 84 86 85 92 87 7.8 100 Urban 42 27 DSL4 AHS 18 CapitalCare Dickinsfield 81 90 94 93 87 92 85 83 84 98 92 9.3 88 Urban 14 9 DSL3 AHS 19 Garneau Hall 86 93 96 94 72 75 92 81 94 90 80 7.7 89 Urban 37 9 DSL4 Priv 20 Copper Sky Lodge 93 90 91 89 83 77 88 83 86 92 87 8.1 94 Urban 130 54 DSL4 Priv 21 Lifestyle Options - Terra Losa 89 90 92 91 86 83 88 80 83 93 85 7.4 92 Urban 77 15 DSL4 NP 22 Devonshire Manor 93 93 88 91 79 73 82 75 90 91 89 8.3 93 Urban 59 27 DSL4 Priv 23 Chartwell Aspen House 86 92 93 89 84 77 93 79 90 97 83 7.9 92 Urban 72 14 DSL4 AHS 24 Chartwell St. Albert 92 90 92 90 79 76 83 73 82 94 86 8.0 95 Urban 70 22 DSL4 Priv

USING THE RESULTS AND OVERVIEW OF FINDINGS 8 Table 1: Summary of 2019 site results (continued)

Dimensions of Care

type

Edmonton Zone Order

(N = 36 sites) Spaces Choice Facility Facility Geography General General Laundry DSL4, Both) Services Resident Resident Care and Activities Employee Propensity to Operator Employees Satisfaction Number of DSL Environment Environment Recommend (%) Respondents (N) Meals & Dining & Meals Communication responsiveness Overall Care Rating Care Overall Level Care of (DSL3, Relationship with 25 Sprucewood Place 85 91 91 84 86 82 90 83 84 94 83 7.2 75 Urban 93 22 DSL4 Priv 26 Grand Manor 89 88 87 87 91 87 89 75 86 91 80 7.9 80 Urban 102 22 DSL4 NP Rutherford Heights Retirement 27 91 88 90 84 79 81 85 74 86 88 85 7.5 86 Urban 89 26 DSL4 Priv Residence 28 Chateau Vitaline 87 91 89 88 80 75 86 75 77 90 85 8.0 91 Urban 46 12 DSL4 NP Good Samaritan Society Wedman 29 91 86 94 89 66 77 91 81 90 92 80 7.2 80 Urban 30 17 DSL4 NP House 30 Rosedale Estates 90 87 84 90 73 77 85 64 83 95 86 7.7 100 Urban 50 21 Both Priv 31 CapitalCare Laurier House Lynnwood 90 90 83 84 74 76 83 78 81 92 87 7.6 92 Urban 80 39 DSL4 AHS 32 Chartwell Griesbach 85 85 89 90 82 77 85 78 81 82 80 7.3 83 Urban 165 26 DSL4 Priv 33 Saint Thomas Health Centre 89 87 87 86 76 70 84 80 83 89 80 7.8 94 Urban 138 36 DSL4 NP 34 Salvation Army Grace Manor 87 87 83 81 83 77 82 69 80 86 72 7.3 69 Urban 87 30 DSL4 NP 35 Villa Marguerite 83 86 90 85 78 74 78 74 86 83 74 6.8 69 Urban 239 52 DSL4 Priv Summerwood Village Retirement 36 85 87 85 82 74 79 90 72 85 83 72 7.0 67 Urban 79 7 DSL4 Priv Residence

Dimensions of Care

Central Zone

Order (N = 36 sites) Choice Facility Facility Geography General General Laundry DSL4, Both) Resident Resident Activities Employee Propensity to Operator type Operator Employees Satisfaction Environment Environment Recommend (%) Respondents (N) Meals & Dining & Meals Communication responsiveness Overall Care Rating Care Overall Level Care of (DSL3, Relationship with Care and Services and Care Number of DSL Spaces 1 Vermilion Valley Lodge 98 99 96 100 81 85 97 95 95 100 94 8.7 92 Rural 40 14 DSL3 NP 2 Pioneer House 97 94 94 93 84 83 85 89 90 95 90 8.5 100 Rural 44 11 DSL4 NP 3 Eckville Manor House 95 92 92 96 84 94 94 83 95 100 94 8.8 100 Urban 15 11 DSL3 NP 4 Bashaw Meadows 92 96 91 94 82 89 95 90 91 93 94 8.3 92 Rural 30 15 DSL4 NP 5 Hillview Lodge 95 92 94 93 83 80 90 85 83 94 89 8.4 94 Rural 36 18 DSL3 NP

USING THE RESULTS AND OVERVIEW OF FINDINGS 9

Table 1: Summary of 2019 site results (continued)

Dimensions of Care

type

Central Zone Order

(N = 36 sites) Spaces Choice Facility Facility Geography General General Laundry DSL4, Both) Services Resident Resident Care and Activities Employee Propensity to Operator Operator Employees Satisfaction Number of DSL Environment Environment Recommend (%) Respondents (N) Meals & Dining & Meals Communication responsiveness Overall Care Rating Care Overall Level Care of (DSL3, Relationship with 6 Coronation Hospital and Care Centre 91 95 96 95 85 77 93 91 93 100 80 8.0 82 Rural 19 11 DSL3 AHS 7 Vegreville Manor 95 90 92 96 82 87 93 88 90 97 87 6.0 100 Rural 15 6 DSL3 NP 8 Royal Oak Manor 91 94 92 95 88 72 88 81 81 98 84 7.8 92 Rural 111 27 Both Priv 9 Wetaskiwin Meadows 92 96 91 96 74 81 87 86 90 100 86 8.2 86 Rural 26 14 DSL3 NP 10 Sundre Seniors Supportive Living 92 93 96 93 81 78 89 84 84 100 83 8.3 100 Rural 40 6 DSL4 NP 11 Providence Place 96 91 92 92 91 80 94 82 94 96 91 8.2 100 Rural 16 6 DSL3 NP 12 Points West Living Wainwright 93 92 91 95 84 74 87 77 87 85 83 7.6 92 Rural 59 14 DSL4 Priv 13 Points West Living Lloydminster 93 89 95 95 86 85 90 93 91 95 90 8.4 91 Rural 60 13 DSL4 Priv 14 Century Park 99 90 95 88 78 83 80 78 86 90 95 8.5 100 Rural 40 6 DSL4 Priv 15 Seasons Retirement Ponoka 89 93 98 94 85 63 89 83 89 98 74 7.3 55 Rural 20 12 DSL3 Priv 16 West Park Lodge 94 93 90 87 71 86 86 83 87 91 90 8.6 100 Urban 36 13 DSL4 Priv 17 Seasons Retirement Wetaskiwin 95 89 88 96 81 80 85 77 87 100 86 7.9 100 Rural 20 7 DSL3 Priv 18 Extendicare Michener Hill 93 91 91 83 82 79 87 75 78 82 81 7.3 88 Urban 60 16 DSL4 Priv 19 Islay Assisted Living 92 93 82 89 78 81 82 81 88 93 86 7.8 100 Rural 20 12 DSL3 AHS 20 Park Avenue At Creekside 94 89 91 94 80 76 87 83 73 75 81 8.0 83 Rural 40 8 DSL4 Priv 21 Bethany Meadows 89 92 95 90 80 72 91 80 92 94 80 8.1 84 Rural 30 20 DSL4 NP 22 Heritage House 91 92 88 92 81 76 88 73 78 96 72 7.3 75 Rural 42 12 DSL4 Priv 23 Seasons Retirement Olds 86 91 91 96 74 86 89 81 78 96 78 7.3 55 Rural 20 13 DSL3 Priv 24 Seasons Drayton Valley 92 91 89 92 79 65 82 87 79 90 79 6.9 78 Rural 16 10 DSL3 Priv 25 Points West Living Stettler 91 92 91 88 70 78 83 76 74 89 81 7.9 89 Rural 88 29 DSL4 Priv 26 Clearwater Centre 92 91 85 83 57 78 82 68 75 82 81 7.3 82 Rural 39 18 Both NP 27 Seasons Retirement Camrose 89 92 85 90 72 71 87 86 87 80 78 7.8 86 Rural 82 15 DSL4 Priv 28 Faith House 89 90 84 95 61 89 93 72 88 93 77 7.1 71 Rural 20 7 DSL3 NP 29 Points West Living Red Deer 85 90 88 87 75 80 82 72 84 91 90 7.1 95 Urban 114 21 DSL4 Priv 30 Viewpoint 89 84 90 84 62 80 82 80 86 100 73 7.0 80 Rural 20 13 DSL3 NP

USING THE RESULTS AND OVERVIEW OF FINDINGS 10 Table 1: Summary of 2019 site results (continued)

Dimensions of Care

Central Zone Both) Order

(N = 36 sites) Spaces Choice Facility Facility Geography General General Laundry Services DSL4, Resident Resident Care and Activities Employee Propensity to Operator type Operator Employees Satisfaction Number of DSL Environment Environment Recommend (%) Respondents (N) Meals & Dining & Meals Communication responsiveness Overall Care Rating Care Overall Level Care of (DSL3, Relationship with Good Samaritan Good Shepherd 31 85 86 89 87 81 74 78 75 79 78 81 7.6 96 Rural 69 28 DSL4 NP Lutheran Home 32 Timberstone Mews 88 86 84 89 65 75 78 76 78 92 84 8.2 95 Urban 60 20 DSL4 Priv 33 Bethany Sylvan Lake 82 88 87 91 60 73 82 77 79 97 81 7.2 91 Urban 21 13 DSL4 NP 34 Sunset Manor 82 86 84 88 80 70 76 71 82 76 76 7.6 81 Rural 102 21 Both Priv 35 Seasons Encore Olds 88 88 87 76 65 69 77 73 66 69 78 7.7 93 Rural 60 15 DSL4 Priv 36 Villa Marie 88 80 85 86 66 68 73 72 74 84 76 6.9 85 Urban 106 40 DSL4 NP

Dimensions of Care

Calgary Zone Order

(N = 28 sites) Spaces Choice Facility Facility Geography General General Laundry DSL4, Both) Services Resident Resident Care and Activities Employee Propensity to Operator type Operator Employees Satisfaction Number of DSL Environment Environment Recommend (%) Respondents (N) Meals & Dining & Meals Communication responsiveness Overall Care Rating Care Overall Level Care of (DSL3, Relationship with 1 Prince of Peace Manor 94 96 94 96 88 86 94 89 89 100 96 8.4 100 Urban 30 14 DSL4 Priv Carewest Colonel Belcher Care 2 94 94 94 94 83 89 92 81 92 92 93 8.6 94 Urban 30 16 DSL4 AHS Centre McKenzie Towne Retirement 3 96 93 97 96 88 74 94 95 91 94 90 8.3 92 Urban 42 12 DSL4 Priv Residence 4 Revera Heartland 93 95 93 94 88 82 88 86 90 100 88 7.8 95 Urban 40 22 DSL4 Priv 5 Providence Care Centre 96 92 92 95 84 77 94 90 94 98 84 7.9 79 Urban 56 15 DSL4 NP 6 Evanston Grand Village 96 94 92 87 80 77 87 78 86 90 90 8.1 95 Urban 102 25 DSL4 Priv 7 St. Marguerite Manor 94 93 93 90 82 73 86 84 89 87 90 8.3 96 Urban 102 27 DSL4 NP 8 AgeCare Sagewood 93 92 91 93 87 77 86 87 89 99 89 8.0 92 Rural 110 28 DSL4 Priv 9 Edgemont Retirement Residence 92 91 95 92 92 81 91 86 89 95 82 7.2 82 Urban 31 14 DSL4 Priv 10 AgeCare Walden Heights 92 93 91 94 78 71 85 84 88 96 86 7.5 91 Urban 238 90 DSL4 Priv 11 Aspen Ridge Lodge 95 86 91 94 81 82 86 88 83 100 85 8.6 89 Rural 30 10 DSL4 NP 12 Scenic Acres Retirement Residence 89 94 92 91 80 83 94 81 90 100 90 8.0 100 Urban 26 9 DSL4 Priv

USING THE RESULTS AND OVERVIEW OF FINDINGS 11

Table 1: Summary of 2019 site results (continued)

Dimensions of Care

Calgary Zone Order

(N = 28 sites) Spaces Choice Facility Facility Geography General General Laundry DSL4, Both) Services Resident Resident Care and Activities Employee Propensity to Operator type Operator Employees Satisfaction Number of DSL Environment Environment Recommend (%) Respondents (N) Meals & Dining & Meals Communication responsiveness Overall Care Rating Care Overall Level Care of (DSL3, Relationship with 13 Strafford Foundation Tudor Manor 91 93 90 91 84 76 86 85 84 90 86 8.1 92 Urban 152 50 DSL4 NP 14 Wentworth Manor The Residence 89 91 97 91 82 84 86 86 80 98 86 8.3 94 Urban 62 18 DSL4 NP Whitehorn Village Retirement 15 92 91 91 92 84 80 90 86 87 95 90 7.8 100 Urban 53 20 DSL4 Priv Community 16 Kingsland Terrace 91 91 95 93 79 83 91 89 88 93 82 8.0 87 Urban 24 16 DSL4 Priv 17 Swan Evergreen Village 85 92 92 93 81 83 84 92 91 88 87 7.8 90 Urban 48 12 DSL4 Priv 18 Holy Cross Manor 92 92 92 91 81 73 85 83 90 90 85 7.6 96 Urban 100 27 DSL4 NP 19 AgeCare Seton 93 89 91 92 80 75 84 82 86 92 85 7.8 90 Urban 252 78 DSL4 Priv 20 Bethany Didsbury 90 93 90 93 74 77 87 84 87 97 84 7.7 97 Rural 100 34 DSL4 NP 21 Carewest Nickle House 91 93 85 84 52 94 84 97 88 93 83 7.8 83 Urban 10 6 DSL4 AHS 22 Sage Hill Retirement Residence 91 89 89 89 81 75 86 79 89 83 84 7.7 93 Urban 72 15 DSL4 Priv 23 Silver Willow Lodge 92 89 90 90 72 73 84 85 85 95 73 8.1 93 Rural 38 16 Both AHS 24 St. Teresa Place 90 91 89 91 73 65 84 82 82 88 82 7.5 87 Urban 250 56 DSL4 NP 25 Seasons Retirement High River 91 89 88 88 76 73 86 82 84 91 86 8.1 94 Rural 108 36 DSL4 Priv 26 Eau Claire Retirement Residence 91 87 85 88 76 72 84 82 82 90 83 7.9 90 Urban 73 13 DSL4 Priv 27 Monterey Place 83 86 88 86 81 74 87 73 76 92 80 7.6 91 Urban 107 26 DSL4 Priv 28 Millrise Place 87 85 86 89 73 54 74 73 77 85 68 6.0 58 Urban 40 14 DSL4 Priv

Dimensions of Care

South Zone Order

(N = 28 sites) Spaces Choice Facility Facility Geography General General Laundry Services DSL4, Both) Resident Resident Care and Activities Employee Propensity to Operator type Operator Satisfaction Number of DSL Relationship Environment Environment Recommend (%) Respondents (N) Meals & Dining & Meals with Employees Communication responsiveness Overall Care Rating Care Overall Level Care of (DSL3, 1 AgeCare Orchard Manor 98 97 97 100 91 94 91 94 97 88 93 8.3 100 Rural 25 8 DSL3 Priv 2 Chinook Lodge 94 98 95 98 83 79 92 91 97 91 97 8.8 100 Rural 20 13 DSL3 NP 3 Meadowlands Retirement Residence 98 96 89 94 95 85 93 85 88 100 86 7.3 83 Urban 10 6 DSL4 Priv

USING THE RESULTS AND OVERVIEW OF FINDINGS 12 Table 1: Summary of 2019 site results (continued)

Dimensions of Care

South Zone

Order (N = 28 sites) Choice Facility Facility Geography General General Laundry DSL4, Both) Resident Resident Activities Employee Propensity to Operator type Operator Employees Satisfaction Environment Environment Recommend (%) Respondents (N) Meals & Dining & Meals Communication responsiveness Overall Care Rating Care Overall Level Care of (DSL3, Relationship with Care and Services and Care Number of DSL Spaces Cypress View Foundation Medicine 4 96 92 94 95 86 83 92 82 92 76 90 8.3 92 Urban 45 25 DSL3 NP Hat 5 Sunny South Lodge 93 95 94 94 86 86 91 88 90 89 95 8.5 100 Urban 53 24 Both NP 6 Good Samaritan Society Prairie Ridge 95 92 94 95 86 85 92 93 87 95 91 8.1 100 Rural 85 22 DSL4 NP 7 Clearview Lodge 94 93 92 92 86 91 92 90 94 89 92 8.6 100 Rural 20 14 DSL3 NP Good Samaritan Society West 8 94 93 93 94 87 84 89 86 90 92 91 8.5 96 Urban 100 46 DSL4 NP Highlands 9 Golden Acres Lodge 95 93 92 94 81 85 93 87 92 97 92 8.2 100 Urban 45 22 DSL3 NP 10 Good Samaritan Garden Vista 92 92 93 92 86 82 87 82 94 88 89 8.6 100 Rural 35 8 DSL4 NP 11 Masterpiece Southland Meadows 93 91 91 94 84 84 90 90 92 88 92 8.2 100 Urban 50 18 DSL4 Priv Good Samaritan Society Pincher 12 92 93 89 94 83 87 89 85 92 94 91 7.9 96 Rural 75 27 Both NP Creek Vista Village 13 York Creek Lodge 93 90 90 95 82 80 86 94 92 92 89 7.9 86 Rural 20 7 DSL3 NP 14 Meadow Ridge Seniors Village 93 93 94 88 76 76 80 83 79 92 82 7.5 85 Urban 84 13 DSL4 Priv 15 Haven Care Centre 91 92 93 91 89 77 93 89 90 63 91 8.1 100 Urban 24 12 DSL4 NP 16 The Wellington Retirement Residence 91 96 89 91 76 76 86 82 85 90 86 7.9 92 Urban 50 27 DSL4 Priv 17 AgeCare Sunrise Gardens 92 93 83 85 76 78 80 75 77 88 90 7.8 91 Rural 84 25 DSL4 Priv 18 AgeCare Columbia 87 91 94 94 77 78 82 81 87 91 82 7.2 77 Urban 50 25 DSL3 Priv 19 Good Samaritan Society Lee Crest 93 90 90 90 75 76 85 86 89 88 83 8.3 89 Rural 95 28 DSL4 NP 20 Extendicare Fairmont Park 91 91 89 91 76 72 85 84 86 90 86 7.9 94 Urban 140 37 DSL4 Priv Good Samaritan Society South Ridge 21 91 91 91 87 79 74 90 78 83 92 83 7.9 92 Urban 48 13 DSL4 NP Village 22 River Ridge Seniors Village 92 90 89 92 81 72 91 88 87 94 87 8.1 89 Urban 36 9 DSL4 Priv 23 Legacy Lodge 90 90 89 87 78 75 82 84 85 87 84 7.6 90 Urban 104 53 DSL4 Priv Good Samaritan Society Park 24 90 89 90 89 77 76 88 87 85 89 82 7.5 93 Urban 121 31 DSL4 NP Meadows Village 25 St. Therese Villa 90 88 88 88 80 77 81 80 82 86 87 7.6 90 Urban 200 57 DSL4 NP 26 Good Samaritan Society Linden View 88 89 87 88 73 74 82 75 80 91 77 7.4 86 Rural 105 22 DSL4 NP

USING THE RESULTS AND OVERVIEW OF FINDINGS 13

Table 1: Summary of 2019 site results (continued)

Dimensions of Care

South Zone

Order (N = 28 sites) Choice Facility Facility Geography General General Laundry DSL4, Both) Resident Resident Activities Employee Propensity to Operator type Operator Employees Satisfaction Environment Environment Recommend (%) Respondents (N) Meals & Dining & Meals Communication responsiveness Overall Care Rating Care Overall Level Care of (DSL3, Relationship with Care and Services and Care Number of DSL Spaces 27 Piyami Place 90 88 74 82 71 76 79 86 77 83 74 7.6 100 Urban 15 5 DSL4 NP 28 St. Michael's Health Centre 89 88 88 89 69 72 82 76 87 98 82 7.5 75 Urban 72 12 DSL4 NP

USING THE RESULTS AND OVERVIEW OF FINDINGS 14 1.3 What are the actions for improvement? In response to stakeholder requests for assistance in interpreting the survey results and identifying improvement opportunities, the HQCA further examined the individual questions from the survey. The survey questions were prioritized according to greatest opportunity for improvement based on (1) the strength of the question as an influencer of overall resident experience (i.e. Overall Care Rating), and (2) the question’s room for improvement (i.e., the lower the score the more room for improvement). From this analysis, the top five survey questions provincially, are presented below. Because this analysis was conducted at the respondent-level, the averages of all respondents (N=2,857) are presented as opposed to the averages of the 145 eligible sites as in the rest of the report.

Per cent in 2019

Q30: Can you get the foods you like? (% Yes, Always) (N = 2621) 33

Q60: In the last 6 months, have you been a part of a Resident and Family Council Meeting? (% Yes) 34 (N = 2415)

Q29: Is the food here tasty? (% Yes, Always) (N = 2797) 37

Q54: In the last 6 months, how often did you feel that there were enough nurses and aides at the facility? (% Yes, Always) 43 (N = 2515)

Q3: Are you satisfied with the activities offered here? (% Yes, Always) 50 (N = 2552)

From these top five survey questions, the HQCA determined Actions for Improvement. If implemented, these actions have the greatest potential to improve overall resident experience at the provincial level (i.e., increase the Overall Care Rating). For more details, see Appendix X. While this type of analysis is new to this survey iteration, select results from previous iterations are presented, where available, to provide additional support for the Actions for Improvement from the residents’ perspective. It is important to note that the survey is one source of information that can inform improvement priorities. Other quality measures such as those derived from the interRAITM Resident Assessment Instrument (RAI), complaints and concerns, accreditation results, and CCHSS compliance should also be considered along with resident characteristics such as level of need and average age. The Actions for Improvement provide one possible use or interpretation of the survey findings. Stakeholders may choose to interpret the findings differently depending on their role and specific context in the continuing care system.

USING THE RESULTS AND OVERVIEW OF FINDINGS 15

Actions for Improvement Action 1: Food

 Alberta Health Services and contracted designated supportive living owner and operators collaborate with residents to fully understand resident’s food preferences and develop strategies to improve variety and taste of food as well as manage residents’ expectations.

Provincially, only 33 per cent of residents felt that they could Always get the foods they like (Question 30) and only 37 per cent of residents felt that the food is Always tasty (Question 29).

Similarly in 2016, only 32 per cent of residents felt that they could Always get the foods they like and only 38 per cent of residents felt that the food is Always tasty. Furthermore in 2013-14, 34 percent felt that they could Always get the foods they like and 40 per cent felt that the food is Always tasty. Action 2: Resident and Family Council  Alberta Health Services and contracted designated supportive living owner and operators collaborate with residents to ensure that residents are aware of their ability to form a Resident and Family Council and, where they exist, engage with Resident and Family Councils to ensure residents are aware of meetings, and determine if there are any other barriers to resident participation.

Provincially, only 34 per cent of residents said Yes they were part of a Resident and Family Council meeting in the last six months (Question 60)12 and only 50 per cent of residents answered Yes their facility has a Resident and Family Council (Question 59)1. Action 3: Staffing  Alberta Health, Alberta Health Services, and contracted designated supportive living owner and operators collaborate with residents to fully understand residents’ concerns regarding staffing levels of nurses and aides, and develop strategies to address these concerns. Only 43 per cent of residents felt there were Always enough nurses and aides in the site, provincially (Question 54).

Similarly in 2016, only 40 per cent of residents felt there were Always enough nurses and aides in the site.

1 These two questions were new to the 2019 survey.

USING THE RESULTS AND OVERVIEW OF FINDINGS 16 Action 4: Activities  Alberta Health Services and contracted designated supportive living owner and operators collaborate with residents to fully understand residents’ activity needs and develop strategies to meet their needs and manage their expectations.

Provincially, 50 per cent of residents said they were Always satisfied with the activities offered (Question 3).

Previous survey iterations showed 52 per cent of residents were Always satisfied with the activities offered in 2016, and 54 per cent were Always satisfied in 2013-14.

USING THE RESULTS AND OVERVIEW OF FINDINGS 17

2.0 BACKGROUND

2.1 Designated Supportive Living2 Alberta’s continuing care system provides Albertans of advanced age or disability with the healthcare, personal care, and accomodation services they need to support their daily activities, independence, and quality of life. There are three streams of continuing care in Alberta tailored to the client’s level of need and/or limitations: home care, supportive living, and long-term care (or facility living), (Figure 1, below).

. Home care is provided to those still able to live independently. . Supportive living is provided in a shared accomodation setting recognizing different degrees of independence.

. Long-term care (or facility living) includes long-term care sites like nursing homes and auxiliary hospitals.

Figure 1: Three streams of the continuing care system Three Streams of the Continuing Care System Home Care Supportive Living Facility Living Independent A congregate setting that combines accommodation services with other supports and Living care (e.g., House, Non-Designated Designated Supportive Living (DSL) Long-Term Care Apartment and Supportive Living (LTC) Facility Condominium) (e.g., Lodges, A congregate setting that provides (i.e., Nursing Group Homes and additional support with on-site health care Homes and Congregate staff Auxiliary Settings) Hospitals) DSL- 3 DSL- 4 DSL 4- Publicly funded Publicly funded Dementia 24-hour on-site health care is health care is 24-hour on- 24-hour on- 24-hour on- health care provided provided through site care site care site care services provided through the the Home Care provided by provided by provided by by a diverse mix of Home Care Program health care health care health care health care Program staff* staff* staff* in a professionals** therapeutic and health care environment staff *Health care staff in DSL 3, 4 and 4D may include Health Care Aides, Therapy Assistants and Licensed Practical Nurses. **Health care professionals in LTC may include Registered Nurses, Licensed Practical Nurses, Health Care Aides, Occupational and Physical Therapists and Physicians.

Supportive living is an option for individuals who want a maintenance-free environment, feel they are too isolated in their own home, or have more complex needs than those provided for by home care. To some extent, individuals can choose which supportive living option is right for them. Based on an assessment of their needs by Alberta Health Services (AHS), individuals may be eligible for a space or a

2 For more information, see http://www.health.alberta.ca/services/continuing-care-system.html

BACKGROUND 18 room in publicly funded Designated Supportive Living (levels 3, 4 and 4D).3 Although services for assessed care needs are publicly funded, residents are generally responsible for paying for their room, meals, housekeeping, and other optional services. Supportive living sites are not required to provide on- site 24-hour registered nurses or regularly scheduled visits by physicians.

The defined levels in the Supportive Living stream4 are: . Supportive Living Level 1 (SL1): This level of care is also referred to as Residential Living and is designed for individuals who are independent, can manage most daily tasks, and are responsible for making decisions around their day-to-day activities. Publicly funded home care may be provided, but there is no on-site 24-hour staffing.

. Supportive Living Level 2 (SL2): This level of care is also referred to as Lodge Living and is designed for individuals who are generally independent (e.g., can manage some daily tasks), and can arrange, manage, and/or direct their own care. Publicly funded home care may be continually provided, but there is no on-site 24-hour staffing.

. (Designated) Supportive Living Level 3 (DSL3): This level of care is for individuals whose medical condition is stable and appropriately managed without 24-hour on-site nursing staff, but who have limited independence. These individuals need help with many tasks and/or decision-making in day-to-day activities. Personal care at this level is generally provided within a set schedule; however, unscheduled personal assistance may also be provided. Publicly funded scheduled home care may be provided, and trained and certified healthcare aide staff are on-site on a 24-hour basis (registered nurse on-call).

. (Designated) Supportive Living Level 4 (DSL4): This level of care is also referred to as Enhanced Assisted Living and is for individuals with more complex medical conditions. These individuals tend to have very limited independence, have significant limitations, and need help with most or all tasks, as well as decisions about day-to-day activities. Publicly funded scheduled home care may be provided, and a trained licensed practical nurse and/or healthcare aide is on- site on a 24-hour basis.

. (Designated) Supportive Living Level 4 Dementia (DSL4-D): This level of care is a subset of DSL4 and is designed for persons who have significant limitations due to dementia. The focus of this report and the results presented are for DSL (levels 3 and 4). As of September 2019, there were over 11,600 publicly funded spaces dedicated to DSL in Alberta. DSL sites are operated under three ownership models (AHS, private, and not-for-profit).5 All are required to adhere to provincial standards to ensure residents are in a safe and comfortable environment and receive quality services. These standards are described in Box A below and include: CCHSS,6 The

3 Designated Assisted Living or Designated Supportive Living refers to designated rooms in the supportive living stream that are operated under contract with AHS. Individuals are assessed and placed by AHS based on an individual’s healthcare needs. 4 For more information, see http://www.albertahealthservices.ca/assets/info/seniors/if-sen-living-option-guidelines.pdf 5 The site categorization is based on AHS definitions. 6 Continuing Care Health Service Standards. More information can be found here: https://open.alberta.ca/publications/9781460138441

BACKGROUND 19

Supportive Living Accommodation Standards and Checklist,7 Supportive Living Accommodation Licensing Act,8 and Admission Guidelines for Publicly Funded Continuing Care Living Options.9 Referring to these standards while reviewing this report may provide context and help to better focus improvement efforts. Resident observations and perceptions alone are not sufficient to evaluate a site’s compliance with a specific standard.

Box A: Standards

Continuing Care Health Service Standards: The Continuing Care Health Service Standards (CCHSS) are a legislated requirement of operators pursuant to the Nursing Homes General Regulation and under the Nursing Homes Act, the Co-ordinated Home Care Program Regulation under the Public Health Act and pursuant to a ministerial directive under the Regional Health Authorities Act. The CCHSS set the minimum requirement that operators in the continuing care system must comply with in the provision of healthcare.

Supportive Living Accommodation Standards and Checklist: The Alberta government sets provincial accommodation standards, and monitors compliance to the standards through annual site inspections. The standards apply to accommodation and related services such as facility maintenance, meals, housekeeping, and areas that impact a resident’s safety and security. Each accommodation is inspected at least once a year, and more often if required. An operator must meet all accommodation standards to achieve compliance.

Supportive Living Accommodation Licensing Act: All supportive living accommodations must be licensed when the operator provides permanent accommodation to four or more adults and the operator provides or arranges for services related to safety and security of the residents as well as at least one meal a day or housekeeping services.

Admission Guidelines for Publicly Funded Continuing Care Living Options: The intent of the Alberta Health Services Living Option guidelines is to provide a set of support tools to assist with consistent living option decisions in relation to supportive living levels 3 and 4 and long-term care.

7 Supportive Living Accommodation Standards and Checklist. More information can be found here: http://www.health.alberta.ca/documents/CC-Supportive-Living-Standards-2010.pdf 8 Licensing and accommodation standards: http://www.health.alberta.ca/services/supportive-living.html 9 Admission Guidelines for Publicly Funded Continuing Care Living Options. More information can be found here: http://www.albertahealthservices.ca/assets/info/seniors/if-sen-living-option-guidelines.pdf

BACKGROUND 20

2.2 HQCA’s Designated Supportive Living Resident Experience Survey The HQCA conducted the Designated Supportive Living Resident Experience Survey in collaboration with Alberta Health Services (AHS) and Alberta Health (AH). The survey results can be used as one source of evidence to meet Standard 19: Quality Improvement Reporting under the CCHSS and are meant to support a culture of continual quality improvement that is evidence-based.

The 2019 survey is the third iteration of the survey, the previous iterations were in 2016 and 2013-14. 2.2.1 Purpose The overall purpose of the survey was to obtain feedback from residents about the quality of care and services they receive at DSL sites across Alberta. The feedback is used to describe the current state of DSL from the residents’ perspective and to provide DSL sites and other stakeholders with information that can be used for ongoing quality monitoring and improvement. 2.2.2 Objectives The objectives of the survey were to:

. Conduct a follow-up to previous iterations of the HQCA’s Designated Supportive Living Resident Experience Survey.

. Identify potential improvement opportunities and report on areas of success at DSL sites across Alberta to inform quality improvement efforts.

2.3 HQCA’s Designated Supportive Living Family Experience Survey Concurrent to the resident experience survey, the HQCA conducted a family experience survey, which surveyed family members of residents in DSL sites via a mail-in paper and on-line survey. The results of this survey can be found in a separate report, the HQCA’s Designated Supportive Living Family Experience Survey.10

10 http://hqca.ca/surveys/supportive-living-family-resident-experience-survey/

BACKGROUND 21

3.0 SURVEY PROCESS AND METHODOLOGY

3.1 The survey instrument Residents of DSL sites were surveyed using a modified version of the Ohio Residential Care Facility Survey (Appendix I) developed by the Scripps Gerontology Centre and funded by the Ohio Department of Aging. This is a 64‐question instrument that assesses the resident’s overall experience with a DSL site (i.e., Overall Care Rating), whether they would recommend the site (Propensity to Recommend), along with 11 Dimensions of Care. In addition to the above, the survey includes ten additional questions that assess other aspects of care and services important to the experiences of residents such as transportation to and from medical appointments and questions about Resident and Family Councils.

3.2 Survey sampling The survey was conducted as a census of all eligible DSL residents. Eligible residents were identified using a compiled database obtained from AHS and confirmed by site staff. Residents were excluded if, for example, the resident was limited by cognitive ability. For a complete list of exclusion criteria, see Appendix II. Survey data collection occurred from May to September 2019. The overall response rate for the survey was 60 per cent; 2,857 out of a possible 4,761 eligible residents completed the survey. Nearly two-thirds of completed surveys were via in-person interview (1,824 of 2,857). For a breakdown of sampling, see Appendix II.

3.3 Survey protocol and survey type The questionnaire was completed either as: (1) a self‐administered paper survey, or (2) an in‐person administration of the survey (referred to in this report as “in-person interview”). RAI data and feedback from site staff was used to assign residents to either a self‐administered paper survey or to an in‐person interview.11 To accommodate resident preference, eligible residents were also provided with the option of choosing the alternate type of survey at the time of the site visit. Paper surveys were also mailed directly to residents in remote sites.12 Completed paper surveys were accepted from May to September 2019. 3.3.1 Enacted personal directives Residents with enacted personal directives (as identified by site staff) were not surveyed unless site staff or HQCA staff obtained consent from the resident’s agent. Otherwise, a survey package was sent to the resident’s agent requesting the resident’s participation. If the agent consented, the agent was instructed to deliver the survey package to the resident to complete. For more details, see Appendix II.

11 The decision to implement a dual‐modality survey delivery protocol was informed by a pilot study that found in general there were no significant differences in response to survey questions based on survey type used, which supported treating both paper survey and in‐ person interviews as equally valid modes for completing the survey. For an analysis based on survey modality, see Appendix III. 12 Remote sites are defined as sites greater than 220 km away from any of the following locations: Grande Prairie, Edmonton, Red Deer, Calgary, or Lethbridge.

SURVEY PROCESS AND METHODOLOGY 22 3.4 Quantitative analytical approach 3.4.1 Site inclusion for site-level analyses To maximize the reliability of site-level results and to maintain respondent anonymity, a site’s data was included in site-level analyses only if:

. The site yielded five or more respondents; AND, . The site response margin of error was equal to or less than 10 per cent and/or the site had a response rate of over 50 per cent among eligible respondents. As a result, 145 of the 166 participating sites were used to calculate the zone and provincial averages. Data from sites that did not meet the above criteria may still receive an individual site-level report (see Appendix V). For this report, a test was deemed statistically significant if the probability of the event occurring by chance alone was less than or equal to one per cent (p < 0.01). 3.4.2 Dimensions of Care Each Dimension of Care represents a set of questions or topics that share a similar conceptual theme. Dimension of Care scores were computed by summarizing all the items within a Dimension of Care into an average score on a 0 to 100 scale. A Dimension of Care score was generated for all respondents who answered a minimum number of questions within the Dimension of Care. For each survey question within a Dimension of Care, a scoring method was used to transform responses to a scaled score between 0.0-100.0, where higher scores represent more positive experiences and lower scores represent more negative experiences. The scaled scores were then weighted based on how strongly each question related to the particular Dimension of Care, relative to all other questions within the Dimension of Care. For example, questions that relate more strongly to a Dimension of Care would be weighted slightly more heavily than the other questions within the same Dimension of Care. Dimension of Care scores were then calculated by summing individual scaled and weighted survey items and dividing the total score by the number of items within each Dimension of Care (creating an average score out of 100). (for detailed methodology, see Appendix II). For complete question-level results, see Appendix VIII.

SURVEY PROCESS AND METHODOLOGY 23

3.4.3 Modelling A structural equation model was constructed to examine the relative influence of each Dimension of Care on the Overall Care Rating. This analysis showed a significant association between the Dimensions of Care and the Overall Care Rating (for detailed results, see Appendix IX) which are listed below in order of decreasing strength of association:

1. Facility Environment 7. Communication 2. Resident Environment 8. Care and Services 3. Choice 9. Employee Responsiveness 4. Relationship with Employees 10. Laundry 5. Activities 11. General Satisfaction 6. Meals and Dining

Within this report, results are presented as ordered above.13

13 Dimensions 7 to 9 are ordered based on the strength of association with the Overall Care Rating examined in isolation. In addition, General Satisfaction was not included in modelling given that the dimension addressed topics of general experience which the Overall Care Rating already addresses. Dimension of Care Laundry could not be feasibly included in modelling given that the number of respondents greatly restricted the sample and there were only two questions in that dimension which could not form a latent construct in the structural equation model.

SURVEY PROCESS AND METHODOLOGY 24 4.0 2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS

4.1 Overall Care Rating The Overall Care Rating is a single item intended to reflect a resident’s overall opinion about the site and asks: Using any number from 0 to 10, where 0 is the worst and 10 is the best…Overall, what number would you use to rate your home? In 2019, the average Overall Care Rating for the 145 eligible sites was 7.8 out of 10; individual site averages ranged from 6.0 to 9.3 out of 10 and there were no significant differences between AHS Zones (for site-level results of the 145 eligible sites see Appendix VII). When comparing 2019 and 2016 results, there were no significant differences provincially or by AHS Zone.

Average score (0 to 10)

9.3 (highest 6.0 (lowest scoring site) 7.8 (average) scoring site) Alberta 6.0 7.9 9.6

6.3 7.7 9.2 North Zone 6.1 7.9 9.6

6.8 7.8 9.3 Edmonton 6.1 7.7 9.2 Zone

6.0 7.8 8.8 Central Zone 6.6 7.9 9.0

6.0 7.9 8.6 Calgary Zone 6.0 7.9 9.4

7.2 8.0 8.8 South Zone 7.3 8.2 9.5

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 25 4.2 Propensity to Recommend An important indicator of residents’ perception of the quality of a site is whether a resident would recommend the site to someone needing DSL care. For this reason, Q50 in the Dimension of Care General Satisfaction is presented in this section separately and asks: Would you recommend this place to a family member or friend? Yes or No? The four possible responses to this question were collapsed into a Yes or No response, and represent the Propensity to Recommend percentage (i.e., the percentage of residents who said Yes they would recommend their site):

YES NO

Yes, always No, hardly ever

Yes, sometimes No, never

In 2019, the average Propensity to Recommend percentage for the 145 eligible sites was 90 out of 100; individual site averages ranged from 55 to 100 out of 100 and there were no significant differences between AHS Zones (for site-level results of the 145 eligible sites see Appendix VII). When comparing 2019 and 2016 results, there were no significant differences provincially or by AHS Zone.

Average score (0% to 100%)

100 (highest 55 (lowest scoring site) 90 (average) scoring site) Alberta 38 91 100

60 89 100 North Zone 80 94 100

67 90 100 Edmonton 50 87 100 Zone

55 88 100 Central Zone 75 91 100

58 91 100 Calgary Zone 38 90 100

75 93 100 South Zone 76 93 100

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 26 4.3 Dimension of Care: Facility Environment Residents were asked to reflect on their experiences on a range of topics regarding the building in which they live. The following five questions were asked, and are listed in order of their potential to improve overall resident experience: Q36: Do you like the location of this place? Q38: Does this place look attractive to you? Q39: Is this place clean enough? Q37: Are the outside walkways and grounds well taken care of? Q40: Is this place quiet when it should be? In 2019, the average Facility Environment score for the 145 eligible sites was 91 out of 100; individual site averages ranged from 81 to 99 out of 100 and there were no significant differences between AHS Zones (for site-level results of the 145 eligible sites see Appendix VII). When comparing 2019 and 2016 results, there were no significant differences provincially or by AHS Zone.

Average score (0 to 100)

91 (average) 99 (highest 81 (lowest scoring site) scoring site) Alberta 75 92 100

82 90 97 North Zone 89 93 100

81 91 97 Edmonton 75 90 99 Zone

82 91 99 Central Zone 80 91 99

83 92 96 Calgary Zone 78 93 99

87 92 98 South Zone 85 92 97

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 27 The top-box results (% of residents that chose Yes, always) for each question in this Dimension of Care is presented below by AHS Zone. For the other response options to these questions by AHS Zone, see Appendix VIII.

Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone % % % % % % Q36: Do you like the location of this place? (N = 2,626) (N = 204) (N = 705) (N = 496) (N = 643) (N = 578) Yes, always 72 74 73 63 72 78 Q38: Does this place look attractive to you? (N = 2,669) (N = 207) (N = 720) (N = 491) (N = 660) (N = 591) Yes, always 75 74 76 63 79 81 Q39: Is this place clean enough? (N = 2,811) (N = 220) (N = 748) (N = 526) (N = 703) (N = 614) Yes, always 81 80 80 78 85 81 Q37: Are the outside walkways and grounds well taken care of? (N = 2,531) (N = 194) (N = 671) (N = 469) (N = 633) (N = 564) Yes, always 81 79 80 71 85 86 Q40: Is this place quiet when it should be? (N = 2,798) (N = 222) (N = 734) (N = 529) (N = 702) (N = 611) Yes, always 76 77 78 75 78 72

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 28 4.4 Dimension of Care: Resident Environment Residents were asked to reflect on their experiences on a range of topics regarding the room in which they live. The following six questions were asked, and are listed in order of their potential to improve overall resident experience: Q42: Are you satisfied with your room or apartment? Q44: Are your belongings safe here? Q45: Do you think this is a pleasant place for people to visit? Q41: Do you have enough privacy in your room or apartment? Q43: Do you feel safe here? Q46: Is the room temperature comfortable for you? In 2019, the average Resident Environment score for the 145 eligible sites was 91 out of 100; individual site averages ranged from 80 to 99 out of 100 and there were no significant differences between AHS Zones (for site-level results of the 145 eligible sites see Appendix VII). When comparing 2019 and 2016 results, there were no significant differences provincially or by AHS Zone.

Average score (0 to 100)

91 (average) 99 (highest 80 (lowest scoring site) scoring site) Alberta 79 92 99

81 91 98 North Zone 87 92 99

85 91 98 Edmonton 79 92 98 Zone

80 91 99 Central Zone 82 92 99

85 91 96 Calgary Zone 79 92 96

88 92 98 South Zone 84 92 97

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 29 The top-box results (% of residents that chose Yes, always) for each question in this Dimension of Care is presented below by AHS Zone. For the other response options to these questions by AHS Zone, see Appendix VIII.

Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone % % % % % % Q42: Are you satisfied with your room or apartment? (N = 2,818) (N = 221) (N = 747) (N = 530) (N = 706) (N = 614) Yes, always 79 81 80 72 79 82 Q44: Are your belongings safe here? (N = 2,758) (N = 215) (N = 735) (N = 521) (N = 684) (N = 603) Yes, always 76 82 76 73 77 74 Q45: Do you think this is a pleasant place for people to visit? (N = 2,715) (N = 217) (N = 715) (N = 504) (N = 682) (N = 597) Yes, always 80 82 81 68 83 84 Q41: Do you have enough privacy in your room or apartment? (N = 2,816) (N = 221) (N = 747) (N = 526) (N = 708) (N = 614) Yes, always 82 86 83 82 83 81 Q43: Do you feel safe here? (N = 2,811) (N = 220) (N = 743) (N = 528) (N = 711) (N = 609) Yes, always 84 87 84 76 84 90 Q46: Is the room temperature comfortable for you? (N = 2,806) (N = 217) (N = 743) (N = 526) (N = 708) (N = 612) Yes, always 61 57 64 52 63 63

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 30 4.5 Dimension of Care: Choice Residents were asked to reflect on the choices they have at their site. The following six questions were asked, and are listed in order of their potential to improve overall resident experience: Q9: Are the rules here reasonable? Q6: Do the employees leave you alone if you don’t want to do anything? Q8: Are you free to come and go as you are able? Q10: Can you choose what clothes to wear? Q7: Do the people who work here encourage you to do the things you are able to do yourself? Q5: Can you go to bed when you like? In 2019, the average Choice score for the 145 eligible sites was 91 out of 100; individual site averages ranged from 74 to 98 out of 100 and there were no significant differences between AHS Zones (for site- level results of the 145 eligible sites see Appendix VII). When comparing 2019 and 2016 results, there were no significant differences provincially or by AHS Zone.

Average score (0 to 100)

98 (highest 74 (lowest scoring site) 91 (average) scoring site) Alberta 76 91 99

82 91 98 North Zone 86 90 99

83 91 97 Edmonton 83 91 96 Zone

82 90 98 Central Zone 81 89 96

85 91 97 Calgary Zone 77 91 98

74 90 97 South Zone 76 91 96

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 31 The top-box results (% of residents that chose Yes, always) for each question in this Dimension of Care is presented below by AHS Zone. For the other response options to these questions by AHS Zone, see Appendix VIII.

Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone % % % % % % Q9: Are the rules here reasonable? (N = 2,696) (N = 211) (N = 710) (N = 511) (N = 674) (N = 590) Yes, always 74 79 75 67 74 76 Q6: Do the employees leave you alone if you don’t want to do anything? (N = 2,724) (N = 218) (N = 714) (N = 502) (N = 693) (N = 597) Yes, always 75 78 78 68 78 74 Q8: Are you free to come and go as you are able? (N = 2,741) (N = 217) (N = 710) (N = 516) (N = 699) (N = 599) Yes, always 82 84 83 76 83 87 Q10: Can you choose what clothes to wear? (N = 2,796) (N = 215) (N = 737) (N = 529) (N = 709) (N = 606) Yes, always 90 87 93 86 93 90 Q7: Do the people who work here encourage you to do things you are able to do yourself? (N = 2,637) (N = 208) (N = 693) (N = 507) (N = 644) (N = 585) Yes, always 64 74 68 57 65 59 Q5: Can you go to bed when you like? (N = 2,791) (N = 215) (N = 738) (N = 528) (N = 706) (N = 604) Yes, always 80 78 79 78 83 78

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 32 4.6 Dimension of Care: Relationship with Employees Residents were asked to reflect on the way employees at the site treat them. The following four questions were asked, and are listed in order of their potential to improve overall resident experience: Q16: Can you depend on the employees? Q15: Are the employees courteous to you? Q17: Are the people who work here friendly? Q18: Do the employees treat you with respect? In 2019, the average Relationship with Employees score for the 145 eligible sites was 91 out of 100; individual site averages ranged from 76 to 100 out of 100 and there were no significant differences between AHS Zones (for site-level results of the 145 eligible sites see Appendix VII). When comparing 2019 and 2016 results, there were no significant differences provincially or by AHS Zone.

Average score (0 to 100)

100 (highest 76 (lowest scoring site) 91 (average) scoring site) Alberta 79 92 100

80 90 99 North Zone 86 93 100

81 90 96 Edmonton 79 92 98 Zone

76 91 100 Central Zone 85 92 99

84 91 96 Calgary Zone 81 92 100

82 91 100 South Zone 85 92 98

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 33 The top-box results (% of residents that chose Yes, always) for each question in this Dimension of Care is presented below by AHS Zone. For the other response options to these questions by AHS Zone, see Appendix VIII.

Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone % % % % % % Q16: Can you depend on the employees? (N = 2,739) (N = 218) (N = 707) (N = 525) (N = 688) (N = 601) Yes, always 62 68 61 56 64 63 Q15: Are the employees courteous to you? (N = 2,805) (N = 215) (N = 741) (N = 531) (N = 709) (N = 609) Yes, always 76 80 73 75 79 78 Q17: Are the people who work here friendly? (N = 2,815) (N = 221) (N = 744) (N = 529) (N = 707) (N = 614) Yes, always 76 78 75 72 79 78 Q18: Do the employees treat you with respect? (N = 2,800) (N = 218) (N = 734) (N = 531) (N = 704) (N = 613) Yes, always 78 83 76 73 80 82

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 34 4.7 Dimension of Care: Activities Residents were asked to reflect on the activities their site offered to entertain them or keep them involved. The following four questions were asked, and are listed in order of their potential to improve overall resident experience: Q3: Are you satisfied with the activities offered here? Q1: Do you have enough to do here? Q2: Do you get enough information about the activities offered here? Q4: Can you choose what activities you do here? In 2019, the average Activities score for the 145 eligible sites was 80 out of 100; individual site averages ranged from 49 to 98 out of 100 and there were no significant differences between AHS Zones (for site- level results of the 145 eligible sites see Appendix VII). When comparing 2019 and 2016 results, there were no significant differences provincially or by AHS Zone.

Average score (0 to 100)

98 (highest 49 (lowest scoring site) 80 (average) scoring site) Alberta 65 81 95

49 78 98 North Zone 69 80 87

66 81 91 Edmonton 65 81 93 Zone

57 77 91 Central Zone 66 77 94

52 80 92 Calgary Zone 72 84 95

69 81 95 South Zone 73 83 92

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 35 The top-box results (% of residents that chose Yes, always) for each question in this Dimension of Care is presented below by AHS Zone. For the other response options to these questions by AHS Zone, see Appendix VIII.

Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone % % % % % % Q3: Are you satisfied with the activities offered here? (N = 2,552) (N = 199) (N = 675) (N = 478) (N = 621) (N = 579) Yes, always 50 52 53 45 48 53 Q1: Do you have enough to do here? (N = 2,672) (N = 210) (N = 717) (N = 493) (N = 656) (N = 596) Yes, always 49 49 56 44 49 47 Q2: Do you get enough information about the activities offered here? (N = 2,695) (N = 209) (N = 704) (N = 502) (N = 679) (N = 601) Yes, always 63 62 69 61 62 60 Q4: Can you choose what activities you do here? (N = 2,562) (N = 194) (N = 693) (N = 461) (N = 638) (N = 576) Yes, always 68 71 76 52 69 67

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 36 4.8 Dimension of Care: Meals and Dining Residents were asked to reflect on the food and mealtimes at their site. The following six questions were asked, and are listed in order of their potential to improve overall resident experience: Q30: Can you get the foods you like? Q29: Is the food here tasty? Q31: Is your food served at the right temperature? Q32: Do you like the way your meals are served here?

Q33: Does the food here meet your dietary needs?14 Q28: Do you get enough to eat? In 2019, the average Meals and Dining score for the 145 eligible sites was 79 out of 100; individual site averages ranged from 54 to 96 out of 100 and there were no significant differences between AHS Zones (for site-level results of the 145 eligible sites see Appendix VII). When comparing 2019 and 2016 results, there were no significant differences provincially or by AHS Zone.

Average score (0 to 100)

96 (highest 54 (lowest scoring site) 79 (average) scoring site) Alberta 59 79 93

57 79 91 North Zone 65 80 92

70 79 96 Edmonton Zone 65 78 91

63 78 94 Central Zone 59 79 93

54 77 94 Calgary Zone 61 79 90

72 80 94 South Zone 72 82 93

14 This question was not included in the calculation of the Meals and Dining Dimension of Care summary score but was included in the Meals and Dining latent construct for the structural equation modelling and was shown to have an influence on the Overall Care Rating.

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 37 The top-box results (% of residents that chose Yes, always) for each question in this Dimension of Care is presented below by AHS Zone. For the other response options to these questions by AHS Zone, see Appendix VIII.

Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone % % % % % % Q30: Can you get the foods you like? (N = 2,621) (N = 208) (N = 692) (N = 501) (N = 656) (N = 564) Yes, always 33 40 35 24 31 37 Q29: Is the food here tasty? (N = 2,797) (N = 221) (N = 735) (N = 528) (N = 704) (N = 609) Yes, always 37 47 40 30 34 41 Q31: Is your food served at the right temperature? (N = 2,774) (N = 216) (N = 732) (N = 525) (N = 697) (N = 604) Yes, always 46 54 49 40 43 47 Q32: Do you like the way your meals are served here? (N = 2,752) (N = 215) (N = 727) (N = 520) (N = 692) (N = 598) Yes, always 61 70 62 53 58 66 Q33: Does the food here meet your dietary needs? (N = 2,408) (N = 195) (N = 648) (N = 439) (N = 636) (N = 490) Yes, always 62 68 66 53 61 63 Q28: Do you get enough to eat? (N = 2,805) (N = 221) (N = 738) (N = 524) (N = 708) (N = 614) Yes, always 83 86 84 82 79 85

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 38 4.9 Dimension of Care: Communications Residents were asked to reflect on the communication between themselves and management at the site. The following five questions were asked, and are listed in order of their potential to improve overall resident experience: Q27: Do your problems get taken care of here? Q23: Are the people in charge available to talk with you? Q26: Do you know who to go to here when you have a problem? Q25: Would you feel comfortable speaking to the people in charge about a problem? Q24: Do the people in charge treat you with respect? In 2019, the average Communications score for the 145 eligible sites was 87 out of 100; individual site averages ranged from 67 to 97 out of 100 and there were no significant differences between AHS Zones (for site-level results of the 145 eligible sites see Appendix VII). When comparing 2019 and 2016 results, there were no significant differences provincially or by AHS Zone.

Average score (0 to 100)

97 (highest 67 (lowest scoring site) 87 (average) scoring site) Alberta 60 88 99

80 88 97 North Zone 79 89 99

67 87 96 Edmonton 75 86 95 Zone

73 86 97 Central Zone 73 87 96

74 87 94 Calgary Zone 60 88 97

79 87 93 South Zone 71 89 97

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 39 The top-box results (% of residents that chose Yes, always) for each question in this Dimension of Care is presented below by AHS Zone. For the other response options to these questions by AHS Zone, see Appendix VIII.

Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone % % % % % % Q27: Do your problems get taken care of here? (N = 2,439) (N = 190) (N = 652) (N = 444) (N = 610) (N = 543) Yes, always 57 70 57 48 57 61 Q23: Are the people in charge available to talk with you? (N = 2,485) (N = 204) (N = 649) (N = 469) (N = 603) (N = 560) Yes, always 60 69 63 55 58 61 Q26: Do you know who to go to here when you have a problem? (N = 2,576) (N = 202) (N = 693) (N = 479) (N = 653) (N = 549) Yes, always 68 75 73 62 64 69 Q25: Would you feel comfortable speaking to the people in charge about a problem? (N = 2,656) (N = 203) (N = 696) (N = 499) (N = 680) (N = 578) Yes, always 73 74 75 71 74 70 Q24: Do the people in charge treat you with respect? (N = 2,635) (N = 210) (N = 688) (N = 482) (N = 667) (N = 588) Yes, always 82 86 83 76 83 83

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 40 4.10 Dimension of Care: Care and Services Residents were asked to reflect on the care and services received at the site such as things employees do for them or to help them. The following four questions were asked, and are listed in order of their potential to improve overall resident experience: Q14: Do the employees who take care of you know what you like and you don’t like? Q13: Do the employees explain your care and services to you? Q11: Can you get snacks and drinks whenever you want them? Q12: Do you get your medications on time? In 2019, the average Care and Services score for the 145 eligible sites was 83 out of 100; individual site averages ranged from 64 to 98 out of 100 and there were no significant differences between AHS Zones (for site-level results of the 145 eligible sites see Appendix VII). When comparing 2019 and 2016 results, there were no significant differences provincially or by AHS Zone.

Average score (0 to 100)

98 (highest 64 (lowest scoring site) 83 (average) scoring site) Alberta 66 83 99

76 86 98 North Zone 69 81 99

64 79 91 Edmonton 66 80 91 Zone

68 81 95 Central Zone 74 84 94

73 85 97 Calgary Zone 77 84 97

75 85 94 South Zone 73 84 93

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 41 The top-box results (% of residents that chose Yes, always) for each question in this Dimension of Care is presented below by AHS Zone. For the other response options to these questions by AHS Zone, see Appendix VIII.

Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone % % % % % % Q14: Do the employees who take care of you know what you like and you don’t like? (N = 2,587) (N = 209) (N = 682) (N = 495) (N = 644) (N = 557) Yes, always 51 61 54 39 51 54 Q13: Do employees explain your care and services to you? (N = 2,529) (N = 205) (N = 669) (N = 482) (N = 611) (N = 562) Yes, always 55 68 53 41 58 62 Q11: Can you get snacks and drinks whenever you want them? (N = 2,483) (N = 189) (N = 654) (N = 476) (N = 622) (N = 542) Yes, always 58 72 49 55 58 65 Q12: Do you get your medications on time? (N = 2,655) (N = 214) (N = 706) (N = 491) (N = 660) (N = 584) Yes, always 76 81 80 63 79 76

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 42 4.11 Dimension of Care: Employee Responsiveness Residents were asked to reflect on the availability of employees who work at their site. The following four questions were asked, and are listed in order of their potential to improve overall resident experience: Q20: During the weekend, are employees available to help you if you need it? Q22: Do you feel confident that employees know how to do their jobs? Q19: During the week, are employees available to help you if you need it? Q21: During the evening and night, are employees available to help you if you need it? In 2019, the average Employee Responsiveness score for the 145 eligible sites was 86 out of 100; individual site averages ranged from 66 to 97 out of 100 and there were no significant differences between AHS Zones (for site-level results of the 145 eligible sites see Appendix VII). When comparing 2019 and 2016 results, there were no significant differences provincially or by AHS Zone.

Average score (0 to 100)

97 (highest 66 (lowest scoring site) 86 (average) scoring site) Alberta 73 89 100

77 86 97 North Zone 81 92 100

77 86 97 Edmonton 73 88 96 Zone

66 84 95 Central Zone 80 89 98

76 87 94 Calgary Zone 81 89 99

77 88 97 South Zone 75 88 100

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 43 The top-box results (% of residents that chose Yes, always) for each question in this Dimension of Care is presented below by AHS Zone. For the other response options to these questions by AHS Zone, see Appendix VIII.

Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone % % % % % % Q20: During the weekend, are the employees available to help you if you need it? (N = 2,584) (N = 209) (N = 659) (N = 493) (N = 647) (N = 576) Yes, always 54 55 58 41 55 57 Q22: Do you feel confident that employees know how to do their jobs? (N = 2,747) (N = 215) (N = 724) (N = 522) (N = 696) (N = 590) Yes, always 61 69 60 53 62 67 Q19: During the week, are the employees available to help you if you need it? (N = 2,648) (N = 216) (N = 683) (N = 499) (N = 666) (N = 584) Yes, always 66 70 71 51 70 66 Q21: During the evening and night, are the employees available to help you if you need it? (N = 2,536) (N = 204) (N = 640) (N = 479) (N = 630) (N = 583) Yes, always 65 69 69 47 68 73

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 44 4.12 Dimension of Care: Laundry Residents were asked to reflect on the laundry service at the site. The following two questions were asked, and are listed in order of how strongly they influence this Dimension of Care15: Q34: Do you get your clothing back from the laundry? Q35: Does your clothing come back from the laundry in good condition? In 2019, the average Laundry score for the 145 eligible sites was 92 out of 100; individual site averages ranged from 63 to 100 out of 100 and there were no significant differences between AHS Zones (for site- level results of the 145 eligible sites see Appendix VII). When comparing 2019 and 2016 results, there were no significant differences provincially or by AHS Zone.

Average score (0 to 100)

100 (highest 63 (lowest scoring site) 92 (average) scoring site) Alberta 75 93 100

75 93 100 North Zone 89 95 100

82 92 100 Edmonton 83 93 100 Zone

69 91 100 Central Zone 75 92 100

83 93 100 Calgary Zone 83 93 100

63 89 100 South Zone 76 92 100

15 Laundry was not included in modelling given that the number of respondents greatly restricted the sample and there were only two questions, therefore these questions are not ordered for their potential in improving overall resident experience but instead are presented from strongest to weakest influence on this Dimension of Care.

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 45 The top-box results (% of residents that chose Yes, always) for each question in this Dimension of Care is presented below by AHS Zone. For the other response options to these questions by AHS Zone, see Appendix VIII.

Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone % % % % % % Q34: Do you get your clothing back from the laundry? (N = 1,827) (N = 153) (N = 512) (N = 343) (N = 373) (N = 446) 76 82 79 74 79 72 Q35: Does your clothing come back from the laundry in good condition? (N = 1,827) (N = 147) (N = 502) (N = 343) (N = 371) (N = 464) Yes, always 77 85 80 74 79 73

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 46 4.13 Dimension of Care: General Satisfaction Residents were asked to reflect on their satisfaction with the site in general. The following four questions were asked, and are listed here in order of how strongly they influence this Dimension of Care16:

Q50: Would you recommend this place to a family member or friend?17 Q49: Overall, do you like living here? Q47: Do you feel comfortable here? Q48: Do you feel like you are getting your money’s worth here? In 2019, the average General Satisfaction score for the 145 eligible sites was 85 out of 100; individual site averages ranged from 64 to 100 out of 100 and there were no significant differences between AHS Zones (for site-level results of the 145 eligible sites see Appendix VII). When comparing 2019 and 2016 results, there were no significant differences provincially or by AHS Zone.

Average score (0 to 100)

100 (highest 64 (lowest scoring site) 85 (average) scoring site) Alberta 57 86 99

64 82 100 North Zone 76 85 98

72 86 100 Edmonton 60 84 99 Zone

72 83 95 Central Zone 71 84 97

68 85 96 Calgary Zone 57 88 99

74 87 97 South Zone 78 87 98

16 General Satisfaction was not included in modelling given that the dimension addressed topics of general experience which the Overall Care Rating already addresses therefore these questions are not ordered for their potential in improving overall resident experience but instead are presented from strongest to weakest influence on this Dimension of Care. 17 An important indicator of residents’ perception of the quality of a site is whether a resident would recommend the site to someone needing supportive living care. For this reason, Q50 in the Dimension of Care General Satisfaction is also presented in Section 4.2 separately as Propensity to Recommend.

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 47 The top-box results (% of residents that chose Yes, always) for each question in this Dimension of Care is presented below by AHS Zone. For the other response options to these questions by AHS Zone, see Appendix VIII.

Edmonton Calgary Alberta North Zone Central Zone South Zone Zone Zone % % % % % % Q50: Would you recommend this place to a family member or friend? (N = 2,637) (N = 207) (N = 701) (N = 496) (N = 649) (N = 584) Yes, always 70 71 74 59 70 74 Q49: Overall do you like living here? (N = 2,751) (N = 212) (N = 729) (N = 522) (N = 685) (N = 603) Yes, always 61 61 64 49 61 68 Q47: Do you feel comfortable here? (N = 2,782) (N = 218) (N = 730) (N = 520) (N = 706) (N = 608) Yes, always 77 78 78 68 77 82 Q48: Do you feel like you are getting your money’s worth here? (N = 2,443) (N = 193) (N = 650) (N = 458) (N = 619) (N = 523) Yes, always 56 58 58 44 57 63

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 48 4.14 Additional Care Questions Although the additional care questions were not originally included in the validated questions that make up each Dimension of Care, these questions provide important information about residents’ care and services, and include:

Q59: Does your facility have a Resident and Family Council?18

Q60: In the last 6 months, have you been a part of a Resident and Family Council Meeting? 18

Q61, among those that said Yes to Q60: Do you feel that participating in the Resident and Family Council helped you feel heard about the things that matter to you? 18 Q52: Can you see a doctor if you need to? Q53: Are you able to get transportation to or from medical appointments? Q54: In the last 6 months, how often did you feel that there were enough nurses and aides at the facility? Q55: Do the people who work here take a personal interest in your life? Q56: Do you get your mental health and emotional needs met? Q57: Do you get your healthcare needs met? Q58: Are you involved in making decisions about your care?

18 Questions 59 to 61 were new additions to the 2019 survey and therefore year-year comparisons are not available.

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 49 The top-box results (% of residents that chose Yes, always or Yes) for each Additional Care question is presented below by AHS Zone. For the other response options to these questions by AHS Zone, see Appendix VIII.

Central Calgary South Alberta North Zone Edmonton Zone Zone Zone Zone % % % % % % Q59: Does your facility have a Resident and Family Council? (N = 2,784) (N = 215) (N = 739) (N = 524) (N = 692) (N = 614) Yes 50 54 48 48 49 54 Q60: In the last 6 months, have you been a part of a Resident and Family Council Meeting? (N = 2,415) (N = 178) (N = 672) (N = 427) (N = 605) (N = 533) Yes 34 44 28 36 35 35 Q61: Do you feel that participating in the Resident and Family Council helped you feel heard about the things that matter to you? (Among those who answered Yes to Q60) (N = 761) (N = 70) (N = 180) (N = 146) (N = 193) (N = 172) Yes, 50 61 53 36 50 52 always Q52: Can you see a doctor if you need to? (N = 2,581) (N = 207) (N = 698) (N = 481) (N = 635) (N = 560) Yes, 63 66 67 51 63 70 always Q53: Are you able to get transportation to or from medical appointments? (N = 2,297) (N = 180) (N = 638) (N = 413) (N = 524) (N = 542) Yes, 68 71 69 54 70 76 always Q54: In the last 6 months, how often did you feel that there were enough nurses and aides at the facility? (N = 2,515) (N = 197) (N = 668) (N = 490) (N = 623) (N = 537) Always 43 37 45 33 51 43 Q55: Do the people who work here take a personal interest in your life? (N = 2,551) (N = 206) (N = 676) (N = 487) (N = 643) (N = 539) Yes, always 43 52 42 40 42 44 Q56: Do you get your mental health and emotional needs met? (N = 2,323) (N = 178) (N = 627) (N = 443) (N = 575) (N = 500) Yes, always 54 52 56 43 56 59 Q57: Do you get your healthcare needs met? (N = 2,639) (N = 210) (N = 701) (N = 501) (N = 656) (N = 571) Yes, always 68 71 70 60 69 73 Q58: Are you involved in making decisions about your care? (N = 2,565) (N = 198) (N = 698) (N = 466) (N = 637) (N = 566) Yes, always 52 51 57 40 56 53

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 50 4.14.1 Resident and Family Councils Resident and Family Councils provide a voice to DSL communities and can help make positive changes to the care, services, and quality of life of residents. In April of 2018, the Resident and Family Councils Act, came into effect that gives residents and families the right to establish self-governing councils.19 Three questions regarding Resident and Family Councils (Q59-Q61) were added to this iteration of the survey, providing a unique opportunity to explore resident perspectives with respect to Resident and Family Councils. The averages of the 145 eligible sites are presented here and therefore may differ slightly from the averages of all respondents presented in the table in the previous section.

The average percentage of residents who said Yes, my site has a Resident and Family Council was 49 per cent (Q59) for the 145 eligible sites. Individual site averages ranged from 0 to 100 per cent. There were no significant differences between AHS Zones.

% Yes 100 (highest scoring 0 (lowest scoring site) site) Alberta 49 (average)

North Zone 0 54 100

Edmonton Zone 17 49 100

Central Zone 0 48 83

Calgary Zone 9 45 78

South Zone 0 52 83

19 https://www.alberta.ca/resident-family-councils.aspx

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 51 The average percentage of residents that said Yes, they were a part of a Resident and Family Council Meeting in the last six months was 35 per cent (Q60) for the 145 eligible sites. Individual site averages ranged from 0 to 90 per cent. There were no significant differences between AHS Zones.

% Yes

0 (lowest scoring site) 90 (highest scoring site) Alberta 35 (average)

North Zone 18 44 90

Edmonton Zone 0 29 86

Central Zone 0 35 73

Calgary Zone 8 35 80

South Zone 0 34 73

The residents who said Yes to being part of a Resident and Family Council Meeting were also asked a follow-up question: whether they felt heard about the things important to them (Q61). Due to the small per-site sample sizes for this question, the results cannot be reported by AHS Zone. For the respondent- level results, see Appendix VIII.

2019 AND 2016 PROVINCIAL AND AHS ZONE RESULTS 52 5.0 SITE CHARACTERISTICS

The results in this section present the influence that level of care for the site, site size, geography, site operator type, and building age, have on the Overall Care Rating, Propensity to Recommend, and Dimensions of Care. Analyses were conducted at the provincial level (145 sites), and all site characteristics were considered simultaneously in order to adjust for confounding effects.

5.1 Level of care For the purpose of analyses and to simplify reporting, DSL3 only sites were compared to all other types of sites (referred to as “Rest”), which can have DSL4 level of care only or a combination of both DSL4 and DSL3 levels of care. These sites were combined as initial analyses did not show substantial differences between these types of sites. Generally, DSL3 only sites tend to have higher scores on average than the other sites, (Table 2 below). The Relationship with Employees Dimension of Care showed DSL3 sites were more positive than the other sites, while the other measures showed no statistically significant relationship with site level of care.

Table 2: Level of care: DSL3 versus Rest (N = 145 sites)

DSL3 only Rest20 Measure Statistical Significance (N = 24 sites) (N = 121 sites) Overall Care Rating (0-10) 7.9 7.8 No Propensity to Recommend (%) 88 90 No Dimensions of Care (0 to 100) DSL3 only Rest Measure Statistical Significance (N = 24 sites) (N = 121 sites) Facility Environment 92 91 No

Resident Environment 92 91 No Choice 92 90 No Relationship with Employees 94 90 DSL3 > Rest Activities 81 79 No Meals and Dining 82 78 No Communication 89 87 No Care and Services 85 82 No Employee Responsiveness 89 85 No General Satisfaction 87 85 No Laundry 95 91 No

20 DSL4 level of care or a combination of both DSL4 and DSL3.

SITE CHARACTERISTICS 53 5.2 Site size: Number of DSL spaces

Site size was measured by the number of DSL spaces at each site.21 This data was collected from AHS at the time of survey rollout. The 145 sites eligible for site-level analyses ranged from 10 to 252 DSL spaces. Generally, smaller sites (50 spaces or less) had higher scores than larger sites (51 spaces or more), (Table 3 below). Specifically for the Meals and Dining, and Communication Dimensions of Care smaller sites had statistically significant higher scores than larger sites.

Table 3: Number of DSL spaces (N = 145 sites)

50 spaces or 51-100 101 spaces or Statistical Measure less spaces more Significance22 (N = 77 sites) (N = 45 sites) (N = 23 sites) Overall Care Rating (0-10) 7.9 7.8 7.7 No Propensity to Recommend (%) 90 90 89 No Dimensions of Care (0 to 100) 50 spaces or 51-100 101 spaces or Statistical Measure less spaces more Significance22 (N = 77 sites) (N = 45 sites) (N = 23 sites) Facility Environment 92 91 89 No

Resident Environment 92 91 89 No Choice 91 90 89 No Relationship with Employees 92 90 89 No Activities 79 80 79 No Meals and Dining 81 78 74 Yes Communication 88 86 84 Yes Care and Services 84 82 80 No Employee Responsiveness 87 85 84 No General Satisfaction 85 85 83 No Laundry 93 91 89 No

21 Data was obtained from AHS’s bi-annual bed survey. Sites included in the HQCA’s analyses (N = 145) ranged in bed numbers from 10 to 252. 22 The statistical analysis was conducted using the actual number of DSL spaces but are presented as categories for the purposes of the table.

SITE CHARACTERISTICS 54 5.3 Operator type Three AHS-defined operator models were examined to determine their impact on residents’ experiences of care and services provided.23 These three operator models are: . AHS – publicly operated by or wholly owned subsidiary of AHS. . Private – owned by a private for-profit organization. . Not-for-profit – owned by a not-for-profit or faith-based organization. In general, not-for-profit sites had on average higher scores compared to the other operator types. For two of the eleven Dimensions of Care, AHS sites had less positive scores and these differences were statistically significant, (Table 4 below).

Table 4: Operator type (N = 145 sites)

AHS Not-for-profit Private Statistical Measure (N = 14 sites) (N = 61 sites) (N = 70 sites) Significance Overall Care Rating (0-10) 7.7 8.0 7.7 No Propensity to Recommend (%) 85 92 89 No Dimensions of Care (0 to 100)

AHS Not-for-profit Private Statistical Measure (N = 14 sites) (N = 61 sites) (N = 70 sites) Significance Facility Environment 89 92 91 Not-for profit > AHS

Resident Environment 91 92 91 No Choice 89 91 91 No Relationship with Employees 89 91 91 No Not-for-profit and Activities 74 80 80 Private > AHS Meals and Dining 78 81 77 No Communication 86 88 86 No Care and Services 83 84 81 No Employee Responsiveness 86 87 85 No General Satisfaction 81 86 84 No Laundry 91 92 91 No

5.4 Site age Site age is defined as the number of years of operation from the build date to 2019, the year the survey took place. The age of sites ranged from one year to 69 years. In general, there was no relationship between site age and any of the key measures.

23 It is recognized there may be other operator models than the three reported above (for example, private not-for-profit housing bodies); however, the choice was made to use operator models defined and categorized by AHS.

SITE CHARACTERISTICS 55

5.5 Geography: Urban versus rural Geography was based on the site’s postal code, and defined as:

. Urban areas:

o Cities of Calgary and Edmonton proper and surrounding commuter communities. o Major urban centres with populations greater than 25,000 and their surrounding commuter communities.

. Rural areas:

o Populations less than 25,000 and/or greater than 200 kilometres away from an urban centre. Of the 145 sites eligible for site-level analyses, 57 were classified as rural, and 88 were classified as urban. There were no statistically significant relationships between geography and the measures, (Table 5 below).

Table 5: Urban versus rural (N = 145 sites)

Urban Rural Measure Statistical Significance (N = 88 sites) (N = 57 sites) Overall Care Rating (0-10) 7.8 7.8 No Propensity to Recommend (%) 90 89 No Dimensions of Care (0 to 100) Urban Rural Measure Statistical Significance (N = 88 sites) (N = 57 sites) Facility Environment 91 92 No

Resident Environment 91 92 No Choice 90 91 No Relationship with Employees 90 92 No Activities 80 79 No Meals and Dining 78 79 No Communication 87 87 No Care and Services 82 84 No Employee Responsiveness 86 86 No General Satisfaction 85 84 No Laundry 92 92 No

SITE CHARACTERISTICS 56 6.0 LIMITATIONS

In interpreting results, there are several important limitations to consider:

1. The effect of sample size. Results become increasingly unreliable as the sample size (i.e., the number of respondents) decreases in relation to the overall population. When giving weight to findings, in particular site-to-site comparisons, readers must consider sample size. To mitigate this, the analyses were limited to sites with reliable sample sizes (145 of 166 sites; see Section 3.4.1 and Appendix V), which are defined as those sites for which respondents reliably represent the site within a predefined margin of error. The criteria for reliability was two-fold: (1) a site with a margin of error of equal to or less than 10 per cent, and (2) a response rate of greater than 50 per cent (for more details, see Appendix V).

2. The effect of the resident profile. Differences in resident profiles must be considered when interpreting the survey results relative to the AHS zone and the province. For example, age and the degree of physical and cognitive impairment of residents may provide context to the interpretation of the survey results, such as explaining why differences exist or do not exist relative to AHS zone and provincial results, and whether these differences are meaningful.

3. The effect of services provided. The survey and its components must also be evaluated relative to the activities and services provided by each site. For example, laundry services may not be a service offered by all sites or used by all residents within each site. This limits the applicability of questions related to laundry for these sites and/or residents.

4. Survey protocol changes. A number of changes were made for the current iteration of the survey in terms of survey protocol to improve the survey process and reliability of the data. While these changes do not impact findings in this iteration of the survey, caution must be employed when interpreting significant differences between survey cycles.

5. Questionnaire changes. The core questions remained identical from the previous iteration of the survey. However, a few questions were added or removed, and are listed in Appendix II, Changes to the questionnaire from 2016. This was done in order to improve the relevance and utility of the survey tool for DSL stakeholders. While these changes do not impact current findings, caution must be employed when interpreting significant differences between survey cycles.

LIMITATIONS 57

7.0 APPENDICES

APPENDIX I: RESIDENT EXPERIENCE SURVEY TOOL (PAPER VERSION)

APPENDIX I 59

APPENDIX I 60

APPENDIX I 61

APPENDIX I 62

APPENDIX I 63

APPENDIX I 64

APPENDIX I 65

APPENDIX I 66

APPENDIX I 67

APPENDIX II: SURVEY PROCESS AND METHODOLOGY

Privacy, confidentiality, and ethical considerations In accordance with the requirements of the Health Information Act of Alberta (HIA), and the Freedom of Information and Protection of Privacy Act (FOIPPA), an amendment to the Health Quality Council of Alberta (HQCA) privacy impact assessment for patient experience surveys was submitted to, and accepted by, the Office of the Information and Privacy Commissioner of Alberta specifically for the Designated Supportive Living Resident Experience Survey. As a provincial custodian, the HQCA follows the HIA and FOIPPA to ensure the security of the information it collects. Potential respondents were informed of the survey’s purpose and process, that participation was voluntary, and that their information would be kept confidential. Those respondents who declined to participate were removed from the survey process. Residents were informed about the survey through posters and pamphlets. A contact number was provided for those who had questions.

HQCA’s Designated Supportive Living Resident Experience Survey The survey tool (Appendix I) The core questions in the Designated Supportive Living Resident Experience Survey was adapted from the Ohio Residential Care Facility Survey, including the sets of questions used for the 11 Dimensions of Care described below. The Ohio survey instrument was developed and tested by Scripps Gerontology Centre at Miami University of Ohio and the Margaret Blenkner Research Institute of Benjamin Rose in Cleveland and implemented state‐wide in 2007 at Ohio long‐term care sites to assess resident experiences. The Scripps group performed the instrument refinement and psychometric evaluation, which involved testing the reliability of the questionnaire as a whole, in addition to Dimension of Care specific construct reliability of the questions within each Dimension of Care. This ensures that questions within a particular Dimension of Care were similar to each other and were within a central conceptual theme. Questions that did not meet the reliability criteria were revised, moved to a more related Dimension of Care, or removed. Several methods were used to achieve the final version of the questionnaire, which involved factor analyses and scale reliability analyses.24 The questionnaire is written in the present tense with questions positively worded. These questions are designed to ask the respondent about their current experience as opposed to past or future experiences. Survey Dimensions of Care The Ohio survey is made up of 11 subscales (i.e., Dimensions of Care): Activities; Choice; Care and Services; Relationship with Employees; Employee Responsiveness; Communication; Meals and Dining;

24 2007 Long‐Term Care Resident Satisfaction Survey, RCF Survey Findings Report, Vital Research, prepared for the Ohio Department of Aging, February 2008.

APPENDIX II 68

Laundry; Facility Environment; Resident Environment; and General Satisfaction. Each Dimension of Care is made up of four to six questions, and a Dimension of Care summary score is produced from specific questions within each Dimension of Care. For a list of these questions, see Appendix I. Additional questions After consultation with stakeholders, the HQCA added 10 additional questions related to care and services (Appendix I). The purpose of the additional care questions was to assess aspects of care important to the experiences of residents not discussed in the questions that make up the Dimensions of Care; for example, transportation to and from medical appointments. These questions and their response options were constructed with wording consistent with the core instrument. Questions about resident demographics (Q62‐64) were also included.

The Overall Care Rating 0 to 10 scale and Q54 In the last 6 months, how often did you feel that there were enough nurses and aides at the facility were taken from the Consumer Assessment of Healthcare Providers and Systems (CAHPS®)25 survey. These questions were taken for the purpose of comparison with other instruments used to measure family and resident experiences in continuing care (such as in the HQCA’s Designated Supportive Living Family Experience Survey Report and the Long‐Term Care Family Experience Survey Reports).

25 For more details on CAHPS please refer to: https://cahps.ahrq.gov/

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Changes to the questionnaire from 2016 The core of the questionnaire (Q1 through Q51) remained identical from the previous iterations of the survey. However, a few questions were added or removed, and are listed below.

Question Change Reason

Discussion with stakeholders revealed this is a primary Q59: Does your facility have a Resident Added avenue for communication of information to residents and and Family Council? question families. Especially relevant given that the Resident and Family Councils Act came into effect April 2018.

Discussion with stakeholders showed interest in resident Q60: In the last 6 months, have you Added participation in the council. Especially relevant given that been a part of Resident and Family question the Resident and Family Councils Act came into effect April Council Meeting? 2018.

Q61: Do you feel that participating in Discussion with stakeholders showed interest in whether the Resident and Family Council helped Added residents felt their voice was heard when they participated you feel heard about the things that question in the council. Especially relevant given that the Resident matter to you? and Family Councils Act came into effect April 2018.

Do the people that work here respond Removed Discussion with stakeholders revealed this question is negatively when you are frustrated? question ambiguous.

A single rating question reveals little information regarding In general, how would you rate your Removed health that may be actioned. Information on aspects of overall health? question overall health can be found in administrative data.

A single rating question reveals little information that may In general, how would you rate our Removed be actioned. Information on aspects of mental and overall mental or emotional health? question emotional health can be found in administrative data.

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Survey response options Each survey question was followed by Yes or No to help the resident decide on an answer category before making a decision on the degree of agreement or disagreement. The survey was designed this way to help accommodate residents with diminished comprehension and/or decision-making capacity (e.g., residents with some degree of cognitive impairment). Once a resident chose either Yes or No, the interviewer followed with:

Would that be yes, always, or yes sometimes? Would that be no, hardly ever, or no never? Similarly, the instructions for the paper version of the survey encouraged residents to think of the questions in this way where each question was immediately followed by Yes or No? The majority of the questions in the Designated Supportive Living Resident Experience Survey have the following response options: . Yes, always . Yes, sometimes . No, hardly ever . No, never . Don’t know/Not applicable Survey scoring The method for scoring the survey involved transforming each valid response to a scaled measure between 0.0-100.0, as shown below, where higher scores represent more positive experiences and lower scores represent more negative experiences.

Four response options

Response option Converted scaled value

Yes, always 100.0

Yes, sometimes 66.67

No, hardly ever 33.33

No, never 0.0

The scoring method then involved the calculation of a summary score for each Dimension of Care using an average of the scaled and weighted response scores within each Dimension of Care:

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1. A Dimension of Care summary score was generated for respondents who answered at least N-2 questions within the associated Dimension of Care.26 For example to generate a Dimension of Care summary score, a Dimension of Care with five questions would need to have at least three questions answered. Respondents who met this minimum criterion had missing values (if any) replaced by the site average for that question.

2. Summary scores for each Dimension of Care were calculated by scaling the survey questions to a 0.0-to-100.0 scale, where 0.0 was the least positive outcome/response and 100.0 was the most positive outcome/response.

3. The scaled scores were then weighted based on how strongly each question related to the Dimension of Care, relative to all other questions within the Dimension of Care. For example, questions that relate more strongly to a Dimension of Care would be weighted slightly more heavily than the other questions within the same Dimension of Care.27

4. Dimension of Care scores were then calculated by summing individual scaled and weighted survey items and dividing the total score by the number of items within each Dimension of Care (creating an average score).

Testing significant differences and identifying opportunities for improvement All statistical tests were tested at a significance of p < 0.01. In all instances the higher the score, the more positive the experience. Therefore, an increase in score would represent a positive result and a decrease would represent a negative result. While statistical significance may help sites identify potential improvement opportunities, there are many factors that influence statistical significance. Areas of care and services that did not show any statistically significant change or difference may still be important.

1. Comparisons between independent means and proportions (e.g., 2019 vs. 2016 results): To meet the criteria of statistically significant difference, the following criteria must be met:

a) For a comparison of means i. Statistically significant using a one-sample t-test. ii. Statistically significant using a non-parametric test. iii. Statistically significant using a one-sample t-test with a condensed sample of those who have a length of stay of three years or less.

26 The N-2 rule does not apply to the Dimension of Care: Laundry, as this Dimension of Care consists of only two questions. 27 The same weight was not used across survey cycles. It was thought that the most appropriate weight, i.e., relative importance of each question, should be determined by the respondent population for each survey year.

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b) For a comparison of proportions i. Statistically significant using a chi2 test. ii. Statistically significant using a chi2 test with a condensed sample of those who have a length of stay of three years or less. Comparing two data points (i.e., survey cycles) may not indicate a “clinically significant” change.

Survey sampling design and recruitment The survey was conducted as a census of all eligible residents. Given the small size of Designated Supportive Living (DSL) sites, random sampling techniques were not required and would have added little value at the expense of increased complexity for a few larger sites where random selection might have been justified. Site recruitment and inclusion criteria Personal care homes (SL1); group or family care homes or lodges (SL2); and special care homes (including mental health support homes and long-term care-only sites) were excluded from participation as were sites that have been in operation for less than one year, and sites where English was not the first language of most or all residents at the site. To meet time and budget constraints, criteria were applied at the site-level to limit the number of in- person interviews conducted across the province. Specifically, DSL sites were divided into non-remote and remote sites, the latter of which were defined as greater than 220 kilometres away from a major urban centre including: Calgary, Edmonton, Red Deer, Grande Prairie, or Lethbridge. Sites deemed geographically remote were sent self-administered paper surveys by mail. The survey team visited all other sites where an in-person interview was administered or a paper survey was delivered to residents for self-administration. All eligible sites were contacted via email before survey rollout and were asked to identify a site-based staff member who could act as the designated site liaison for the survey. Site liaisons were provided with specific written instructions about the following survey processes: dissemination of the HQCA survey communication materials (survey information letters and brochures to staff, residents, and families, as well as posters to be placed in visible common areas around the site); verifying resident and family information; and coding residents with respect to eligibility for participation and survey type. Survey administrator recruitment and training Survey administrators were hired for each major urban centre, which included Calgary, Edmonton, Red Deer, Grande Prairie, and Lethbridge. To accommodate the number of sites located around each urban centre, two interviewers were based out of Calgary, two in red Deer, two in Lethbridge, and four in Edmonton. All interviewers underwent security clearance and an extensive three-day training before the survey roll-out. These training sessions included information about the project, the HQCA’s role and mandate, characteristics of the population under study, relevant Alberta legislation (such as the

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Protection for Persons in Care Act and information and privacy legislation), and ethical principles in research with vulnerable populations. In addition, these sessions covered the survey instrument, survey process and documentation, handling of confidential data, and appropriate ways to communicate with residents who may have cognitive impairments or dementia. The third day involved on-site supervised interviewing at a DSL site. Survey administrators met with the site liaison and were given a tour of the site. With supervision, survey administrators: (1) navigated a site and located residents, (2) approached residents for an interview, (3) conducted an interview and/or distributed a self-administered paper survey, and (4) dealt with refusals. At the end of the day, the team reconvened, shared experiences and debriefed. Throughout the survey data collection period, bi-weekly check-ins by supervisors were conducted which involved the supervisor observing an interview. Any deviations from protocol were course corrected and any potential improvements were conveyed to the interviewer. In addition to bi-weekly in-person meetings, weekly conference calls were held where survey administrators could share their experiences for shared learning and to address any concerns. Site visit protocol Site visits took place from May to September 2019 and generally ranged from two to three days depending on the size of the site and the number of interviewers. During each initial visit, survey administrators located the site liaison and re-validated the resident list noting resident absences or any other changes. Survey administrators then located each resident to conduct either an interview (i.e., in- person survey) or deliver a paper survey following the survey eligibility protocol. If a resident was not located, survey administrators asked staff to help locate that resident and made at least five attempts to locate them. A return visit was then scheduled approximately two weeks from the initial visit. The purpose of the return visit was to: (1) interview any residents that were not interviewed during the first visit, and (2) collect completed paper surveys. General mailing protocol and protocol for residents with enacted personal directives Site staff indicated which residents had an enacted personal directive. The HQCA sent a survey package to the residents’ agent requesting that, upon consent from the agent, the survey package be delivered to the resident to complete. Paper surveys delivered directly to the residents’ designated agent used the following three-stage mailing protocol to ensure maximum participation rates:

• initial mailing of questionnaire packages • postcard reminders to all non-respondents • mailing of questionnaire package with modified cover letter to all non-respondents Resident inclusion/exclusion criteria Eligible respondents were identified with assistance from DSL site liaisons. The HQCA implemented a comprehensive method of selecting residents for participation. Overall, there were two goals in determining resident inclusion/exclusion criteria:

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1. To select residents capable of participating (e.g., not limited by cognitive ability, illness or other physical disabilities that would cause a burden to the resident). 2. To select the appropriate survey type for residents eligible to take part in a survey either through a self-administered paper survey or an in-person interview.28 The full dataset obtained from AHS contained 10,728 DSL residents. First, the following residents were excluded:

• Residents in SL4D. • Residents in non-English speaking sites. • Residents with a cognitive performance scale (CPS) scores of 5 or 6 (severe to very severe cognitive impairment). Next, site liaisons were tasked with updating their site’s resident list to exclude residents who met the following criteria:

• Residents who subsequently moved to another level of care, were discharged, or were deceased. • From the site liaison’s perspective, residents who had moderate to severe cognitive impairment with whom it would be difficult to communicate with and obtain verbal consent. • From the site liaison’s perspective, residents who had a language barrier and with whom it would be difficult to communicate with and obtain verbal consent. • Legally blind and hard of hearing. • From the site liaison’s perspective, residents who may pose a risk to the survey administrator. • Residents who had been at the site for one month or less or were a transitional resident. In total, 5,967 residents were excluded and 4,761 residents were considered eligible for the survey. Among eligible residents, residents were pre-assigned to either a self-administered paper survey or an in-person interview based on CPS and vision scores which was further refined by feedback from site staff. To accommodate resident preferences, the survey administrators provided the option of choosing either an in-person interview or a paper survey on-site. In addition, residents who refused to participate were offered the alternate method to which they were assigned. For more details on survey type pre- assignment, (Table below).

Paper survey criteria Interview criteria

. All eligible residents in small sites (<20 spaces) that . A CPS score of 2, 3 or 4 (moderate to moderate‐ are outside of the city limits of Calgary, Edmonton, severe impairment). Red Deer, Grande Prairie or Lethbridge. . Residents with CPS of 0 or 1 (intact to borderline . Cognitively well residents (CPS score of 0 or 1) with intact cognition) and a vision assessment score of 3 good vision (vision score of 0 to 2). to 4 (highly to severely impaired) or no vision assessment.

28 Priority was given to the self-administered paper survey to control costs.

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Response rates To reduce the potential for “non-response bias”, it is desirable to achieve a high response rate. Of the 10,728 residents in the DSL database, 4,761 (44 per cent) were deemed eligible to participate after all exclusion criteria were applied. A total of 2,857 residents returned a survey or completed an in- person interview and were considered respondents (60 per cent). The main mode of participation was through in-person interviews (N = 1,824), which constituted 64 per cent of all completed survey responses.

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Figure 1: Sample definition – intended sampling frame

All participants

Existing RAI No RAI data available

CPS 0, 1, 2, 3, 4 Non-remote site: preselected to Exclude: CPS 5 or 6 for interview non-remote and CPS 3 to 6 (Intact to for remote sites moderate/severe Remote site: preselected to impairment) survey

CPS 2, 3 or 4 CPS 0, 1 Staff/administrators to (Moderate to moderate/severe determine revised impairment) (Intact to mild eligibility and survey type impairment) on-site Preselect for interview

Vision Score 0, 1, 2 Vision Score 3 to 4 Final eligible sample and (Adequate to moderately No Vision Score (Highly to severely survey type determined impaired) available Remote sites impaired) Residents approached with Preselect for self- Preselect for interview (>220 km from Preselect for interview preselection survey type, administered paper survey Node city OR a <20 DSL space but given the option to site outside of a switch Staff/administrators to Staff/administrators to Staff/administrators to Node city) determine revised determine revised determine revised Preselect for self- eligibility and survey eligibility and survey eligibility and survey administered type on-site type on-site type on-site paper survey

Final eligible sample and Final eligible sample and Final eligible sample and survey type determined survey type determined survey type determined Residents approached Residents approached Residents approached with preselection survey with preselection survey with preselection survey type, but given the option type, but given the option type, but given the option to switch to switch to switch Note: The sampling frame intended to assign residents to modalities of either a self-administered paper survey or in-person interview using the RAI, CPS, and Vision Scale. After this initial preselection of survey type, site administrators and staff revised (when necessary) eligibility and survey type based on predefined criteria. Residents were then approached with this type of survey, and (for residents in non-remote sites) were given the option to switch survey type as per their preference. Node cities are: Calgary, Edmonton, Red Deer, Grande Prairie, and Lethbridge.

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Figure 2: Study flow chart

N = 10,728

Excluded: N = 5,967 (56% of 10,728)

Reasons (n, % of 5,967): • SL4D, LTC, or other non-DSL space (3,143, 53%) • Deceased or no longer at site (982, 16%) • Moderate/severe cognitive impairment (895, 15%) • Non-English site or new site (470, 8%) • Cognitive impairment; via assessment (132, 2%) • Language barrier or legally blind AND hard of hearing (153, 3%) • Invalid address or no contact info for mail-only protocol (71, 1%) • Risk to interviewer (37, <1%) • *Other (84, 1%)

Eligible: N = 4,761 (44% of 10,728)

Non-respondents: N = 1,904 (40% of 4,761)

Reasons (n, % of 1,904): • Non-respondent - paper survey (1,025, 54%) • Refused (638, 34%) • Communication issues (81, 4%) • Incomplete survey (79, 4%) • Could not locate resident (65, 3%) • Other (16, <1%)

Respondents: N = 2,857 (60% of 4,761) • Interview: n = 1,824 (64% of 2, 857) • Paper Survey: n = 1,033 (36% of 2,857)

Notes: * Other includes: site liaison excluded resident from participation; no other reason provided Moderate to severe cognitive impairment as judged by site liaison defined as an inability to communicate with the resident and obtaining verbal consent unlikely.

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Response rates by AHS Zone29

Figure 3: Survey response rates by AHS Zone and province

% respondents

North Zone (N = 440) 51

Edmonton Zone (N = 1,386) 55

Central Zone (N = 848) 63

Calgary Zone (N = 1,176) 61

South Zone (N = 911) 68

Alberta (N = 4,761) 60

Note: Percentages may not always add to 100 per cent due to rounding.

29 Note: When results refer to AHS Zone comparisons, these results refer to zones in which the site in reference is located and the resident resides.

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APPENDIX III: SURVEY MODALITY

The survey type (paper or in-person interview) may affect survey results. This is particularly true for this survey work because the designation of survey type was conditional on characteristics that may have influenced the results, such as CPS. The majority of respondents completed an in-person interview (64 per cent of respondents). Of the 13 key measures, see Table 1 below, only one survey type difference was statistically significant. Specifically, those who were interviewed had higher scores for the Dimension of Care Resident Environment as compared to those who completed a survey on their own. However, the overall difference was one point and not considered substantive. Therefore, it was decided that the results of both survey types would be combined.

Table 1: Key measures by survey type

Sefl-administered paper Key Measures Interview survey

Overall Care Rating (0 to 10) 7.8 7.8

Propensity to Recommend (%) 89 92

Dimensions of Care (0 to 100)

Activities 79 81

Choice 90 91

Care and Services 81 83

Relationship with Employees 91 90

Employee Responsiveness 86 85

Communications 87 86

Meals and Dining 78 77

Laundry 91 91

Facility Environment 91 91

Resident Environment 91 90*

General Satisfaction 85 85

Note: Comparisons were adjusted for gender, age, level of care, length of stay, CPS, and vision score to control for any confounding effects. * Indicates significant difference at < 0.01

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APPENDIX IV: DIFFERENCES BETWEEN 2019 SURVEY AND 2016 SURVEY

Limitations In interpreting results, there are several important limitations to consider:

1. The effect of sample size. Results become increasingly unreliable as the sample size (i.e., the number of respondents) decreases in relation to the overall population. When giving weight to findings, in particular site-to-site comparisons, readers must consider sample size. To mitigate this, the analyses were limited to sites with reliable sample sizes (145 of 166 sites), defined as: (1) a site with a margin of error of equal to or less than 10 per cent, and (2) a response rate of greater than 50 per cent (for more details, see Appendix X in the provincial report).

2. The effect of services provided. Given that sites differ in many ways, the survey and its components must also be evaluated relative to the activities and services provided by each site. For example, laundry services may not be a service offered by all sites, or used by all residents within each site. This may limit the applicability of some questions.

3. Repeat participants. In some cases, a resident may have participated in 2016 and 2019. Statistical tests require an assumption that each respondent’s result is present only in 2016 or 2019, but not both (independence assumption). To mitigate this, we chose a more conservative criterion for significant differences at p < 0.01 rather than the more conventional p < 0.05. In addition, the statistical difference must also persist after conducting the same statistical test limiting the sample to those with a length of stay three years or less (the approximate length between surveys), which eliminates the chance that a resident participated in both survey cycles.

4. Changes to the survey tool. There were a number of changes to the survey protocol and the questionnaire in 2019 to improve the survey process and reliability of the data. While core questions remained identical from the previous iterations of the survey, a few non-core questions were added or removed. For a list of these changes, see Appendix II, Changes to the questionnaire from 2016.This was done in order to improve the relevance and utility of the survey for DSL stakeholders. While these changes do not impact current findings, caution must be employed in interpreting significant differences between survey cycles.

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APPENDIX V: CRITERIA FOR SITE INCLUSION 2019

Criteria:

1. Confidentiality: five or more respondents per site.30 2. < 10 per cent margin of error (with finite population correction). 3. Response rate of > 50 per cent. Of 188 DSL sites, 22 sites were not surveyed for the reasons shown in Table 1 below.

Table 1: Sites not surveyed and reason for exclusion

AHS Zone Site name Reason for exclusion New site; opened less than one year from North Bar V Nook Supportive Living the start of data collection New site; opened less than one year from North Points West Living Lac La Biche the start of data collection Edmonton Balwin Villa SL4-Dementia only

Edmonton CapitalCare McConnell Place North SL4-Dementia only

Edmonton CapitalCare McConnell Place West SL4-Dementia only

Edmonton Chartwell Heritage Valley SL4-Dementia only

Edmonton Edmonton Chinatown Care Centre Language barrier

Edmonton Edmonton People In Need - Bridgeway 2 No DSL spaces

Edmonton Good Samaritan Society Stony Plain Care Centre SL4-Dementia only

Edmonton Kipohtakawmik Elders Lodge Language barrier

Edmonton Lewis Estates Retirement Residence SL4-Dementia only

Edmonton Shepherd's Care Greenfield SL4-Dementia only

Edmonton Wedman Village Homes SL4-Dementia only

Central Eagle View Lodge No DSL spaces

Central Memory Lane SL4-Dementia only

Central Pines Lodge - Piper Creek Foundation No DSL spaces New site; opened less than one year from Central Points West Living Wetaskiwin the start of data collection New site; opened less than one year from Calgary AgeCare Skypointe the start of data collection

30 Public reporting with very few individuals runs the risk of direct or indirect disclosure of a resident’s identity.

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AHS Zone Site name Reason for exclusion

Calgary Prince of Peace Harbour SL4-Dementia only

Calgary Rocky Ridge Retirement Community SL4-Dementia only

Calgary Wing Kei Greenview Language barrier New site; opened less than one year from South Pioneer Lodge the start of data collection Of the 166 surveyed sites, 145 had at least five surveys collected and met the reporting criteria below: (87 per cent of 166 sites; Table 2):

. 117 met both the margin of error and response rate criteria labelled in green. . 28 met EITHER the margin of error criterion OR response rate criterion labelled in yellow. These sites also accounted for 98 per cent of all respondents (2,805 of 2,857) and 97 per cent of all eligible respondents (4,615 of 4,761). Sites with small sample sizes (i.e., small sites) will inherently have more difficulty meeting confidentiality, response rate, and margin of error criteria.

. 21 did not meet either criterion labelled in red and were excluded from public reporting but may still receive an individualized site report.

Table 2: Site inclusion criteria – Included sites

Response Rate Margin of Error AHS Zone Site Name (%) (%) North Emerald Gardens Retirement Residence 83 3 North Grande Prairie Care Centre 58 3 North Mackenzie Place Supportive Living 63 1 North Manoir du Lac 80 3 North Points West Living Peace River 63 4 North Prairie Lake Seniors Community 78 2 North Shepherd's Care Barrhead 54 3 North Smithfield Lodge 52 3 Edmonton CapitalCare Dickinsfield 69 4 Edmonton CapitalCare Laurier House Lynnwood 71 1 Edmonton CapitalCare Laurier House Strathcona 79 1 Edmonton Chartwell Aspen House 88 2 Edmonton Chartwell Country Cottage Retirement Residence 61 4

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Table 2: Site inclusion criteria – Included sites (continued)

Response Rate Margin of Error AHS Zone Site Name (%) (%) Edmonton Chateau Vitaline 75 3 Edmonton Citadel Mews West 87 1 Edmonton Copper Sky Lodge 69 1 Edmonton Devonshire Manor 71 1 Edmonton Emmanuel Home 60 7 Edmonton Garneau Hall 75 4 Edmonton Glastonbury Village (Mews) 62 2 Edmonton Good Samaritan Society George Hennig Place 80 2 Edmonton Good Samaritan Society Spruce Grove Centre 62 3 Edmonton Good Samaritan Society Wedman House 68 2 Edmonton Laurel Heights Retirement Residence 52 1 Edmonton Lifestyle Options - Terra Losa 54 3 Edmonton Lifestyle Options Whitemud 60 3 Edmonton Our Parents' Home 56 9 Edmonton Rosedale Estates 70 2 Edmonton Rutherford Heights Retirement Residence 55 2 Edmonton Shepherds Care Kensington 54 2 Edmonton Summerwood Village Retirement Residence 54 6 Edmonton Tuoi Hac - Golden Age Manor 57 1 Central Bashaw Meadows 63 3 Central Bethany Meadows 74 2 Central Bethany Sylvan Lake 93 2 Central Century Park 50 7 Central Clearwater Centre 82 2 Central Coronation Hospital and Care Centre 69 4 Central Eckville Manor House 92 2 Central Extendicare Michener Hill 57 3 Central Faith House 64 6 Central Good Samaritan Good Shepherd Lutheran Home 70 1 Central Hillview Lodge 55 2 Central Islay Assisted Living 75 3 Central Park Avenue At Creekside 67 5 Central Pioneer House 61 4 Central Points West Living Red Deer 55 2 Central Points West Living Stettler 66 1 Central Points West Living Wainwright 70 3 Central Providence Place 50 7 Central Royal Oak Manor 61 1 Central Seasons Drayton Valley 56 4 Central Seasons Retirement Camrose 58 3

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Table 2: Site inclusion criteria – Included sites (continued)

Response Rate Margin of Error AHS Zone Site Name (%) (%) Central Seasons Retirement Olds 93 2 Central Seasons Retirement Ponoka 67 3 Central Seasons Retirement Wetaskiwin 88 4 Central Vegreville Manor 55 7 Central Sundre Seniors Supportive Living 75 6 Central Seasons Encore Olds 64 2 Central Sunset Manor 58 2 Central Timberstone Mews 65 2 Central Vermilion Valley Lodge 67 3 Central Viewpoint 76 3 Central Villa Marie 82 1 Central West Park Lodge 93 2 Central Wetaskiwin Meadows 78 2 Calgary AgeCare Sagewood 61 1 Calgary AgeCare Seton 53 1 Calgary AgeCare Walden Heights 64 0 Calgary Aspen Ridge Lodge 71 4 Calgary Bethany Didsbury 71 1 Calgary Strafford Foundation Tudor Manor 65 1 Calgary Carewest Colonel Belcher Care Centre 73 2 Calgary Carewest Nickle House 86 5 Calgary Eau Claire Retirement Residence 54 3 Calgary Edgemont Retirement Residence 50 3 Calgary Evanston Grand Village 60 2 Calgary Kingsland Terrace 70 2 Calgary McKenzie Towne Retirement Residence 92 2 Calgary Millrise Place 74 3 Calgary Monterey Place 63 1 Calgary Prince of Peace Manor 78 2 Calgary Providence Care Centre 75 2 Calgary Revera Heartland 79 2 Calgary Sage Hill Retirement Residence 58 3 Calgary Scenic Acres Retirement Residence 60 5 Calgary Seasons Retirement High River 72 1 Calgary Silver Willow Lodge 71 2 Calgary St. Marguerite Manor 57 1 Calgary Swan Evergreen Village 50 3 Calgary Wentworth Manor The Residence 67 2 Calgary Whitehorn Village Retirement Community 69 2 South AgeCare Columbia 64 2

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Table 2: Site inclusion criteria – Included sites (continued)

Response Rate Margin of Error AHS Zone Site Name (%) (%) South AgeCare Orchard Manor 62 5 South Chinook Lodge 93 2 South Clearview Lodge 88 2 South Cypress View Foundation Medicine Hat 71 1 South Extendicare Fairmont Park 60 1 South Golden Acres Lodge 79 2 South Good Samaritan Society Lee Crest 80 1 South Good Samaritan Society Linden View 59 2 South Good Samaritan Society Park Meadows Village 84 1 South Good Samaritan Society Pincher Creek Vista Village 68 1 South Good Samaritan Society Prairie Ridge 73 2 South Good Samaritan Society South Ridge Village 72 3 South Good Samaritan Society West Highlands 71 1 South Legacy Lodge 65 1 South Masterpiece Southland Meadows 53 2 South Meadow Ridge Seniors Village 72 3 South Meadowlands Retirement Residence 67 7 South River Ridge Seniors Village 75 4 South St. Michael's Health Centre 80 3 South St. Therese Villa 66 1 South Sunny South Lodge 65 2 South Haven Care Centre 75 3 South Sunrise Gardens 64 2 South The Wellington Retirement Residence 77 1 North Edson Healthcare Centre 46 7 North Heimstaed Lodge 23 6 North J.B. Wood Continuing Care Centre 41 6 North Mountain View Centre 41 4 North Points West Living Cold Lake 24 6 North Points West Living Slave Lake 27 6 North Stone Brook 48 3 North Vilna Lodge 100 25 North Whispering Pines Seniors Lodge 36 8 Edmonton Chartwell Griesbach 41 2 Edmonton Chartwell St. Albert 45 2 Edmonton Chartwell Wild Rose Cottage 36 8 Edmonton Grand Manor 44 2 Edmonton Riverbend Retirement Residence 42 4 Edmonton Saint Thomas Health Centre 44 1 Edmonton Salvation Army Grace Manor 43 1

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Table 2: Site inclusion criteria – Included sites (continued)

Response Rate Margin of Error AHS Zone Site Name (%) (%) Edmonton Shepherd's Care Vanguard 43 4 Edmonton Shepherd's Garden 49 2 Edmonton Sprucewood Place 32 2 Edmonton St. Albert Retirement Residence 46 4 Edmonton Villa Marguerite 44 1 Central Heritage House 36 3 Central Points West Living Lloydminster 37 3 Calgary Holy Cross Manor 46 1 Calgary St. Teresa Place 47 1 South Good Samaritan Garden Vista 44 5 South Piyami Place 100 35 South York Creek Lodge 100 30 North Pleasant View Lodge 80 10 North Alpine Summit Seniors Lodge 40 24 North Parkland Lodge 25 45 North Spruce View Lodge 22 18 North Vanderwell Heritage Place 29 21 North Chateau Lac St. Anne 50 16 North Elk Point Heritage Lodge 75 15 North Ridgevalley Seniors Home 75 15 North St. Paul Abilities Network (S.P.A.N.) 60 16 North Wildrose Villa 29 10 Edmonton Lifestyle Options - Riverbend 57 11 Edmonton West Country Hearth 100 45 Edmonton Churchill Retirement Community 0 N/A Edmonton Lifestyle Options - Leduc 33 14 Central Chateau Three Hills 17 16 Central Serenity House 0 N/A South Pleasant View Lodge - Bow Island 80 10 South AgeCare Valleyview 20 39 South Leisure Way 17 35 South Piyami Lodge 75 15 South Prairie Rose Lodge 40 11

APPENDIX V 87

APPENDIX VI: 2019 RESPONDENT CHARACTERISTICS

Data obtained from the Resident Assessment Instrument (RAI) (for example gender, age, Cognitive Performance Scale, vision score, and length of stay) was independent of survey data obtained from the Ohio survey instrument tool. Nearly all residents who were deemed eligible for the survey had a completed RAI. This allowed for comparisons between resident respondents and non-respondents (residents who were deemed eligible for the survey but did not participate in the DSL survey) on those variables included in the RAI. The purpose of the following analyses is to explore whether respondents are representative of the population of eligible residents. Detailed results for each attribute are reported in the following pages. Variables included are:

. gender . age . RAI Cognitive Performance Scale (0 to 6) . vision score (0 to 4) . length of stay There were no significant differences between respondents and non-respondents with respect to age, gender, and vision score. Median length of stay was longer for non-respondents compared to respondents. As expected, non-respondents were more cognitively impaired than respondents.

Table 1: Respondent demographics

Respondent Non-respondent Significant difference Gender (% Female) 66 66 No Age (average age in years) 81 years 81 years No CPS Score (average score) 1.3 1.6 Yes Vision Score (average score) 0.4 0.4 No Length of stay (median) 740 days 835 days Yes

Respondent characteristics and differences in Overall Care Ratings The Overall Care Rating (a score from 0 to 10) was compared to select respondent characteristics. Two- level categories such as gender (Male/Female) were assessed using t-tests at an alpha of 0.01 and further supported by a non-parametric rank sum test.

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Table 2: Respondent characteristics and differences in Overall Care Ratings

Significant differences in Overall Care Rating Gender Female respondents had higher Overall Care Ratings than male respondents (7.9 versus 7.7, respectively, p < 0.01). Age (dichotomized at the median 84 years) Respondents below the median age of 84 years had lower Overall Care Ratings than respondents over the median age (7.7 versus 7.9, respectively, p < 0.01). CPS Score (dichotomized at 0 and 1 vs. Respondents with CPS of 0 and 1 had lower Overall Care Ratings 2,3,4) than respondents with CPS 2, 3 or 4 (7.7 versus 7.9, respectively, p < 0.01). Vision Score (dichotomized at 0 to 2 vs 3 to Not significant. 4) Length of stay (dichotomized at the median Not significant. of 740 days)

Length of stay Length of stay is defined as the amount of time in days a resident resided in a site shortly before survey delivery (May 2019). Admission dates (or days since admission to a site) were captured from administrative data. The median length of stay for residents was approximately 740 days for the residents who completed the survey. The association between length of stay and Dimensions of Care were subsequently explored. Generally, residents did not differ in key measures based on their length of stay. Any differences that were statistically significant were small.

Table 3: Resident length of stay

Below Significant Above median of Dimensions of Care Linear association median of difference at the 740 days 740 days median Longer the stay,higher Activities 79 80 No the score Choice Not significant 90 90 No

Care and Services Not significant 82 82 No Longer the stay, lower Relationship with Employees 91 90 Yes the score Employee Responsiveness Not significant 86 85 No

Communications Not significant 86 86 No

Meals and Dining Not significant 77 77 No

Laundry Not significant 92 90 No

Facility Environment Not significant 91 91 No

Resident Environment Not significant 91 91 No

General Satisfaction Not significant 84 85 No

APPENDIX VI 89

APPENDIX VII: 2019 SITE RESULTS

Overall Care Rating The Overall Care Rating is a single item intended to reflect a resident’s overall opinion about the site and asks: Using any number from 0 to 10, where 0 is the worst and 10 is the best…Overall, what number would you use to rate your home? In 2019, the average Overall Care Rating for the 145 eligible sites was 7.8 out of 10 and individual site averages ranged from 6.0 to 9.3 out of 10. Table 1 below summarizes the 2019 site-level Overall Care Ratings and change in score from 2016 by AHS Zone (N = 145 sites).

. When the Change from the 2016 survey is shaded GREEN this indicates that the 2019 score is statistically significantly HIGHER than the 2016 score.

. When the Change from the 2016 survey is shaded ORANGE this indicates that the 2019 score is statistically significantly LOWER than the 2016 score.

. No shade: 2019 and 2016 scores do not significantly differ. . “---" 2016 result unavailable.

Table 1: Overall Care Rating

2019 Results Change North Zone (N = 17 sites) from N Average 2016 Heimstaed Lodge 6 9.2 --- Points West Living Slave Lake 6 8.5 --- Vilna Lodge 10 8.4 --- Stone Brook 13 8.4 +0.7 Grande Prairie Care Centre 15 8.3 --- Smithfield Lodge 11 8.2 +0.5 Shepherd's Care Barrhead 12 8.0 +1.9 ALBERTA AVERAGE --- 7.8 --- NORTH ZONE AVERAGE --- 7.7 --- Mackenzie Place Supportive Living 30 7.7 --- Whispering Pines Seniors Lodge 5 7.6 --- Prairie Lake Seniors Community 18 7.6 --- Emerald Gardens Retirement Residence 10 7.4 -0.4 Points West Living Cold Lake 6 7.2 --- Manoir du Lac 9 7.1 --- Points West Living Peace River 10 7.1 -0.7 Edson Healthcare Centre 5 6.8 --- Hinton Continuing Care Centre 11 6.7 --- J.B. Wood Continuing Care Centre 6 6.3 ---

APPENDIX VII 90

Table 2: Overall Care Rating (continued)

2019 Results Change Edmonton Zone (N = 36 sites) from N Average 2016 CapitalCare Dickinsfield 9 9.3 --- Emmanuel Home 5 8.6 +0.7 Our Parents' Home 5 8.6 --- Good Samaritan Society George Hennig Place 19 8.5 +0.6 Shepherd's Garden 16 8.5 +0.6 Lifestyle Options Whitemud 12 8.4 +0.5 Devonshire Manor 23 8.3 +0.1 Good Samaritan Society Spruce Grove Centre 12 8.3 +0.2 Glastonbury Village (Mews) 21 8.2 +0.7 Tuoi Hac - Golden Age Manor 26 8.2 +0.6 Copper Sky Lodge 50 8.1 +0.5 Chartwell Country Cottage Retirement Residence 11 8.1 +0.3 Chateau Vitaline 12 8.0 -1.1 Chartwell St. Albert 22 8.0 +0.5 Citadel Mews West 30 7.9 -0.1 Chartwell Aspen House 14 7.9 +0.3 Grand Manor 22 7.9 --- CapitalCare Laurier House Strathcona 25 7.8 +0.2 ALBERTA AVERAGE --- 7.8 --- EDMONTON ZONE AVERAGE --- 7.8 --- Saint Thomas Health Centre 35 7.8 +0.5 St. Albert Retirement Residence 10 7.8 --- Laurel Heights Retirement Residence 31 7.7 +1.0 Rosedale Estates 20 7.7 -0.3 Garneau Hall 9 7.7 -0.1 CapitalCare Laurier House Lynnwood 38 7.6 -0.1 Rutherford Heights Retirement Residence 23 7.5 --- Chartwell Wild Rose Retirement Residence 2 7.5 -0.3 Lifestyle Options - Terra Losa 14 7.4 -0.7 Salvation Army Grace Manor 28 7.3 -0.5 Chartwell Griesbach 25 7.3 -0.6 Good Samaritan Society Wedman House 17 7.2 -0.5 Riverbend Retirement Residence 10 7.2 -0.2 Sprucewood Place 21 7.2 +1.1 Shepherd's Care Vanguard 10 7.1 --- Shepherds Care Kensington 21 7.0 -0.5 Summerwood Village Retirement Residence 6 7.0 -1.1 Villa Marguerite 49 6.8 +0.7

APPENDIX VII 91

Table 3: Overall Care Rating (continued)

2019 Results Change Central Zone (N = 36 sites) from N Average 2016 Eckville Manor House 11 8.8 --- Vermilion Valley Lodge 14 8.7 +1.1 West Park Lodge 13 8.6 -0.2 Century Park 4 8.5 --- Pioneer House 11 8.5 --- Hillview Lodge 17 8.4 --- Points West Living Lloydminster 13 8.4 --- Bashaw Meadows 15 8.3 +0.5 Sundre Seniors Supportive Living 6 8.3 --- Wetaskiwin Meadows 14 8.2 -0.3 Timberstone Mews 20 8.2 --- Providence Place 6 8.2 -0.7 Bethany Meadows 17 8.1 --- Park Avenue At Creekside 8 8.0 --- Coronation Hospital and Care Centre 11 8.0 +0.3 Points West Living Stettler 29 7.9 +0.4 Seasons Retirement Wetaskiwin 7 7.9 -1.1 Islay Assisted Living 12 7.8 -0.3 ALBERTA AVERAGE --- 7.8 --- Seasons Retirement Camrose 14 7.8 -0.3 Royal Oak Manor 27 7.8 +0.1 CENTRAL ZONE AVERAGE --- 7.8 --- Seasons Encore Olds 15 7.7 --- Good Samaritan Good Shepherd Lutheran Home 26 7.6 +0.5 Sunset Manor 21 7.6 -0.6 Points West Living Wainwright 14 7.6 -1.4 Extendicare Michener Hill 16 7.3 -0.2 Seasons Retirement Olds 13 7.3 +0.1 Heritage House 10 7.3 +0.4 Clearwater Centre 18 7.3 -0.1 Seasons Retirement Ponoka 12 7.3 -1.0 Bethany Sylvan Lake 13 7.2 -1.6 Faith House 7 7.1 --- Points West Living Red Deer 20 7.1 --- Viewpoint 11 7.0 -1.0 Villa Marie 39 6.9 -0.5 Seasons Drayton Valley 8 6.9 +0.3 Vegreville Manor 5 6.0 -0.7

APPENDIX VII 92

Table 4: Overall Care Rating (continued)

2019 Results Change Calgary Zone (N = 28 sites) from N Average 2016 Carewest Colonel Belcher Care Centre 16 8.6 +0.7 Aspen Ridge Lodge 9 8.6 -0.3 Prince of Peace Manor 14 8.4 +0.6 McKenzie Towne Retirement Residence 12 8.3 -1.1 Wentworth Manor The Residence 17 8.3 +0.3 St. Marguerite Manor 27 8.3 +0.4 Strafford Foundation Tudor Manor 47 8.1 -0.1 Evanston Grand Village 23 8.1 +0.0 Silver Willow Lodge 16 8.1 -0.1 Seasons Retirement High River 34 8.1 +0.8 AgeCare Sagewood 27 8.0 +0.6 Kingsland Terrace 16 8.0 +2.0 Scenic Acres Retirement Residence 8 8.0 0.0 Eau Claire Retirement Residence 13 7.9 --- CALGARY ZONE AVERAGE --- 7.9 --- Providence Care Centre 15 7.9 --- Carewest Nickle House 6 7.8 -0.0 Swan Evergreen Village 12 7.8 --- ALBERTA AVERAGE --- 7.8 --- Revera Heartland 21 7.8 -0.2 AgeCare Seton 76 7.8 -0.3 Whitehorn Village Retirement Community 19 7.8 +0.2 Bethany Didsbury 34 7.7 -0.5 Sage Hill Retirement Residence 15 7.7 --- Monterey Place 25 7.6 +0.4 Holy Cross Manor 27 7.6 -0.1 St. Teresa Place 55 7.5 --- AgeCare Walden Heights 87 7.5 -0.4 Edgemont Retirement Residence 12 7.2 -1.2 Millrise Place 13 6.0 -1.3 2019 Results Change South Zone (N = 28 sites) from N Average 2016 Chinook Lodge 12 8.8 +0.5 Clearview Lodge 14 8.6 +1.0 Good Samaritan Garden Vista 7 8.6 -0.4 Good Samaritan Society West Highlands 44 8.5 +0.1 Sunny South Lodge 23 8.5 +1.0 Cypress View Foundation Medicine Hat 25 8.3 -0.6 Good Samaritan Society Lee Crest 27 8.3 +0.7

APPENDIX VII 93

Table 5: Overall Care Rating (continued)

AgeCare Orchard Manor 8 8.3 0.0 Masterpiece Southland Meadows 17 8.2 --- Golden Acres Lodge 22 8.2 +0.6 Good Samaritan Society Prairie Ridge 21 8.1 -0.5 River Ridge Seniors Village 9 8.1 -0.5 Haven Care Centre 12 8.1 0.0 SOUTH ZONE AVERAGE --- 8.0 --- Good Samaritan Society Pincher Creek Vista Village 27 7.9 -0.4 The Wellington Retirement Residence 26 7.9 +0.1 Good Samaritan Society South Ridge Village 13 7.9 -0.5 Extendicare Fairmont Park 37 7.9 -0.3 York Creek Lodge 7 7.9 +0.5 ALBERTA AVERAGE --- 7.8 --- AgeCare Sunrise Gardens 25 7.8 --- Legacy Lodge 52 7.6 -0.7 St. Therese Villa 54 7.6 -0.3 Piyami Place 5 7.6 -0.8 Good Samaritan Society Park Meadows Village 31 7.5 -0.7 St. Michael's Health Centre 12 7.5 --- Meadow Ridge Seniors Village 13 7.5 -1.0 Good Samaritan Society Linden View 22 7.4 -1.4 Meadowlands Retirement Residence 6 7.3 0.0 AgeCare Columbia 24 7.2 -0.0 Note: Categorical decision rules based on the average extend beyond the first decimal place. In the event of a tie, the lower limit of the confidence interval was used as a sorting criterion from highest to lowest among ties.

APPENDIX VII 94

Propensity to Recommend An important indicator of the quality of a site is whether a resident would recommend the site to someone needing DSL care. For this reason, Q50 in the Dimension of Care General Satisfaction is presented in this section separately, and asks: Would you recommend this place to a family member or friend? Yes or No? The four possible responses to this question were collapsed into a Yes or No response, and represent the Propensity to Recommend percentage (i.e., the percentage of residents who said Yes they would recommend their site):

YES NO

Yes, always No, hardly ever

Yes, sometimes No, never

In 2019, the average Propensity to Recommend percentage for the 145 eligible sites was 90 out of 100 per cent, and individual site averages ranged from 55 to 100 out of 100. Table 2 below summarizes the 2019 site-level Propensity to Recommend averages and change in score from 2016 by AHS Zone (N = 145 sites).

. When the Change from the 2016 survey is shaded GREEN this indicates that the 2019 score is statistically significantly HIGHER than the 2016 score.

. When the Change from the 2016 survey is shaded ORANGE this indicates that the 2019 score is statistically significantly LOWER than the 2016 score.

. No shade: 2019 and 2016 scores do not significantly differ. . “---" 2016 result unavailable.

Table 2: Propensity to Recommend

2019 Results Change North Zone (N = 17 sites) from N Average 2016 Heimstaed Lodge 5 100 --- Vilna Lodge 10 100 --- Stone Brook 12 100 +17 Points West Living Slave Lake 6 100 --- Smithfield Lodge 11 100 +11 Shepherd's Care Barrhead 14 93 +13 Grande Prairie Care Centre 14 93 --- ALBERTA AVERAGE --- 90 --- Prairie Lake Seniors Community 20 90 --- Points West Living Peace River 10 90 -2 Hinton Continuing Care Centre 10 90 --- NORTH ZONE AVERAGE --- 89 ---

APPENDIX VII 95

Table 2: Propensity to Recommend (continued)

Emerald Gardens Retirement Residence 8 88 -3 Manoir du Lac 12 83 --- Points West Living Cold Lake 6 83 --- Mackenzie Place Supportive Living 28 82 --- Whispering Pines Seniors Lodge 5 80 --- Edson Healthcare Centre 5 80 --- J.B. Wood Continuing Care Centre 5 60 --- 2019 Results Change Edmonton Zone (N = 36 sites) from N Average 2016 Our Parents' Home 5 100 --- Lifestyle Options Whitemud 12 100 +11 Chartwell Wild Rose Retirement Residence 5 100 0 Riverbend Retirement Residence 10 100 +8 CapitalCare Laurier House Strathcona 26 100 0 Chartwell Country Cottage Retirement Residence 10 100 +12 Tuoi Hac - Golden Age Manor 26 100 +15 Rosedale Estates 20 100 0 Laurel Heights Retirement Residence 29 100 +24 Chartwell St. Albert 21 95 +6 Glastonbury Village (Mews) 19 95 +1 Shepherd's Garden 17 94 +1 Copper Sky Lodge 51 94 -0 Saint Thomas Health Centre 34 94 +5 Devonshire Manor 27 93 +3 Lifestyle Options - Terra Losa 13 92 -8 Chartwell Aspen House 12 92 -8 CapitalCare Laurier House Lynnwood 36 92 -3 Good Samaritan Society Spruce Grove Centre 11 91 -9 Chateau Vitaline 11 91 -3 ALBERTA AVERAGE --- 90 --- Citadel Mews West 30 90 -7 St. Albert Retirement Residence 10 90 --- EDMONTON ZONE AVERAGE --- 90 --- Good Samaritan Society George Hennig Place 19 89 -3 Garneau Hall 9 89 0 CapitalCare Dickinsfield 8 88 --- Rutherford Heights Retirement Residence 22 86 --- Shepherds Care Kensington 21 86 -4 Emmanuel Home 6 83 -8 Chartwell Griesbach 24 83 -8 Good Samaritan Society Wedman House 15 80 -5

APPENDIX VII 96

Table 2: Propensity to Recommend (continued)

Shepherd's Care Vanguard 10 80 --- Grand Manor 20 80 --- Sprucewood Place 20 75 +8 Villa Marguerite 49 69 +19 Salvation Army Grace Manor 29 69 -10 Summerwood Village Retirement Residence 6 67 -33 2019 Results Change Central Zone (N = 36 sites) from N Average 2016 Century Park 5 100 --- Sundre Seniors Supportive Living 6 100 --- Eckville Manor House 11 100 --- Pioneer House 11 100 --- Providence Place 5 100 0 Vegreville Manor 5 100 +17 Islay Assisted Living 11 100 0 West Park Lodge 13 100 0 Seasons Retirement Wetaskiwin 7 100 +18 Good Samaritan Good Shepherd Lutheran Home 24 96 +11 Timberstone Mews 20 95 --- Points West Living Red Deer 19 95 --- Hillview Lodge 17 94 --- Seasons Encore Olds 15 93 --- Bashaw Meadows 13 92 +5 Vermilion Valley Lodge 13 92 +2 Royal Oak Manor 26 92 +3 Points West Living Wainwright 12 92 -8 Points West Living Lloydminster 11 91 --- Bethany Sylvan Lake 11 91 -9 ALBERTA AVERAGE --- 90 --- Points West Living Stettler 28 89 -2 CENTRAL ZONE AVERAGE --- 88 --- Extendicare Michener Hill 16 88 -13 Wetaskiwin Meadows 14 86 -14 Seasons Retirement Camrose 14 86 -9 Villa Marie 33 85 -0 Bethany Meadows 19 84 --- Park Avenue At Creekside 6 83 --- Clearwater Centre 17 82 -9 Coronation Hospital and Care Centre 11 82 0 Sunset Manor 21 81 -19 Viewpoint 10 80 0

APPENDIX VII 97

Table 2: Propensity to Recommend (continued)

Seasons Drayton Valley 9 78 +3 Heritage House 12 75 -14 Faith House 7 71 --- Seasons Retirement Olds 11 55 -33 Seasons Retirement Ponoka 11 55 -45 2019 Results Change Calgary Zone (N = 28 sites) from N Average 2016 Prince of Peace Manor 12 100 +7 Whitehorn Village Retirement Community 19 100 +5 Scenic Acres Retirement Residence 9 100 0 Bethany Didsbury 30 97 +1 St. Marguerite Manor 25 96 +1 Holy Cross Manor 25 96 +11 Evanston Grand Village 21 95 +6 Revera Heartland 19 95 +6 Seasons Retirement High River 34 94 +8 Carewest Colonel Belcher Care Centre 16 94 -6 Wentworth Manor The Residence 16 94 -2 Sage Hill Retirement Residence 15 93 --- Silver Willow Lodge 14 93 -7 AgeCare Sagewood 26 92 -5 Strafford Foundation Tudor Manor 48 92 -3 McKenzie Towne Retirement Residence 12 92 -8 Monterey Place 23 91 +7 AgeCare Walden Heights 77 91 -1 CALGARY ZONE AVERAGE --- 91 --- ALBERTA AVERAGE --- 90 --- Swan Evergreen Village 10 90 --- Eau Claire Retirement Residence 10 90 --- AgeCare Seton 69 90 -8 Aspen Ridge Lodge 9 89 -11 Kingsland Terrace 15 87 +49 St. Teresa Place 52 87 --- Carewest Nickle House 6 83 -2 Edgemont Retirement Residence 11 82 -12 Providence Care Centre 14 79 --- Millrise Place 12 58 -14 2019 Results Change South Zone (N = 28 sites) from N Average 2016 Chinook Lodge 13 100 +11 Sunny South Lodge 20 100 +9

APPENDIX VII 98

Table 2: Propensity to Recommend (continued)

AgeCare Orchard Manor 8 100 0 Good Samaritan Garden Vista 7 100 0 Masterpiece Southland Meadows 17 100 --- Haven Care Centre 11 100 0 Good Samaritan Society Prairie Ridge 21 100 +6 Clearview Lodge 14 100 0 Golden Acres Lodge 21 100 +11 Piyami Place 5 100 +20 Good Samaritan Society Pincher Creek Vista Village 26 96 +6 Good Samaritan Society West Highlands 45 96 -1 Extendicare Fairmont Park 33 94 -6 Good Samaritan Society Park Meadows Village 30 93 -7 SOUTH ZONE AVERAGE --- 93 --- Good Samaritan Society South Ridge Village 13 92 +1 The Wellington Retirement Residence 25 92 -2 Cypress View Foundation Medicine Hat 24 92 -8 AgeCare Sunrise Gardens 22 91 --- St. Therese Villa 51 90 +1 ALBERTA AVERAGE --- 90 --- Legacy Lodge 50 90 -8 Good Samaritan Society Lee Crest 27 89 -0 River Ridge Seniors Village 9 89 -11 York Creek Lodge 7 86 +6 Good Samaritan Society Linden View 21 86 -9 Meadow Ridge Seniors Village 13 85 -5 Meadowlands Retirement Residence 6 83 -17 AgeCare Columbia 22 77 +1 St. Michael's Health Centre 12 75 --- Note: Categorical decision rules based on the average extend beyond the first decimal place. In the event of a tie, sites are presented by the percentage who answered Yes, Always from highest to lowest and if there was still a tie at this level sites are presented by their Overall Care Ratings from highest to lowest.

APPENDIX VII 99

Dimension of Care: Facility Environment In 2019, the average Facility Environment score for the 145 eligible sites was 91 out of 100, and individual site averages ranged from 81 to 99 out of 100. Table 3 below summarizes the 2019 site-level Facility Environment averages and change in score from 2016 by AHS Zone (N = 145 sites). . When the Change from the 2016 survey is shaded GREEN this indicates that the 2019 score is statistically significantly HIGHER than the 2016 score.

. When the Change from the 2016 survey is shaded ORANGE this indicates that the 2019 score is statistically significantly LOWER than the 2016 score.

. No shade: 2019 and 2016 scores do not significantly differ. . “---" 2016 result unavailable.

Table 3: Facility Environment

2019 Results Change North Zone (N = 17 sites) from N Average 2016 Heimstaed Lodge 5 97 --- Vilna Lodge 10 96 --- Whispering Pines Seniors Lodge 5 96 --- Manoir du Lac 12 94 --- Stone Brook 13 93 +4 Smithfield Lodge 12 91 +1 ALBERTA AVERAGE --- 91 --- Mackenzie Place Supportive Living 30 91 --- Shepherd's Care Barrhead 13 91 +1 NORTH ZONE AVERAGE --- 90 --- Grande Prairie Care Centre 15 90 --- Points West Living Slave Lake 6 90 --- Edson Healthcare Centre 6 90 --- Points West Living Peace River 10 88 -6 Prairie Lake Seniors Community 21 88 --- Points West Living Cold Lake 6 85 --- Emerald Gardens Retirement Residence 8 85 -5 J.B. Wood Continuing Care Centre 7 84 --- Hinton Continuing Care Centre 11 82 ---

APPENDIX VII 100

Table 3: Facility Environment (continued)

2019 Results Change Edmonton Zone (N = 36 sites) from N Average 2016 Our Parents' Home 5 97 --- Chartwell Country Cottage Retirement Residence 11 96 +7 Riverbend Retirement Residence 11 95 +5 Good Samaritan Society George Hennig Place 20 95 +2 Chartwell Wild Rose Retirement Residence 5 95 -2 Tuoi Hac - Golden Age Manor 28 94 +4 Citadel Mews West 33 94 +0 Shepherds Care Kensington 22 94 +4 Good Samaritan Society Spruce Grove Centre 13 94 +3 Shepherd's Garden 16 93 +2 Shepherd's Care Vanguard 10 93 --- St. Albert Retirement Residence 11 93 --- Devonshire Manor 27 93 +0 Copper Sky Lodge 53 93 +0 CapitalCare Laurier House Strathcona 27 92 +1 Glastonbury Village (Mews) 21 92 +2 Chartwell St. Albert 21 92 +3 Laurel Heights Retirement Residence 32 92 +1 ALBERTA AVERAGE --- 91 --- Good Samaritan Society Wedman House 16 91 +0 Emmanuel Home 6 91 -5 Rutherford Heights Retirement Residence 24 91 --- EDMONTON ZONE AVERAGE --- 91 --- Rosedale Estates 21 90 -1 CapitalCare Laurier House Lynnwood 38 90 -3 Saint Thomas Health Centre 36 89 +2 Lifestyle Options Whitemud 12 89 +3 Grand Manor 22 89 --- Lifestyle Options - Terra Losa 15 89 -7 Salvation Army Grace Manor 30 87 -3 Chateau Vitaline 12 87 -9 Garneau Hall 8 86 -5 Chartwell Aspen House 14 86 -6 Chartwell Griesbach 26 85 -6 Sprucewood Place 21 85 +5 Summerwood Village Retirement Residence 7 85 -11 Villa Marguerite 52 83 +6 CapitalCare Dickinsfield 9 81 ---

APPENDIX VII 101

Table 3: Facility Environment (continued)

2019 Results Change Central Zone (N = 36 sites) from N Average 2016 Century Park 6 99 --- Vermilion Valley Lodge 14 98 +7 Pioneer House 10 97 --- Providence Place 6 96 +0 Eckville Manor House 11 95 --- Vegreville Manor 6 95 +16 Seasons Retirement Wetaskiwin 7 95 +1 Hillview Lodge 18 95 --- Park Avenue At Creekside 8 94 --- West Park Lodge 13 94 -1 Points West Living Wainwright 14 93 -5 Extendicare Michener Hill 15 93 +5 Points West Living Lloydminster 12 93 --- Clearwater Centre 18 92 -3 Bashaw Meadows 15 92 +2 Sundre Seniors Supportive Living 6 92 --- Wetaskiwin Meadows 13 92 +2 Islay Assisted Living 12 92 -6 Seasons Drayton Valley 9 92 +8 Royal Oak Manor 27 91 +3 ALBERTA AVERAGE --- 91 --- CENTRAL ZONE AVERAGE --- 91 --- Points West Living Stettler 28 91 +1 Heritage House 12 91 +5 Coronation Hospital and Care Centre 10 91 +2 Seasons Retirement Camrose 15 89 -4 Seasons Retirement Ponoka 12 89 -10 Viewpoint 13 89 +7 Bethany Meadows 19 89 --- Faith House 7 89 --- Timberstone Mews 20 88 --- Seasons Encore Olds 15 88 --- Villa Marie 39 88 -3 Seasons Retirement Olds 13 86 -4 Good Samaritan Good Shepherd Lutheran Home 27 85 -1 Points West Living Red Deer 20 85 --- Bethany Sylvan Lake 13 82 -13 Sunset Manor 21 82 -2

APPENDIX VII 102

Table 3: Facility Environment (continued)

2019 Results Change Calgary Zone (N = 28 sites) from N Average 2016 McKenzie Towne Retirement Residence 12 96 -3 Providence Care Centre 13 96 --- Evanston Grand Village 24 96 +1 Aspen Ridge Lodge 9 95 -3 Carewest Colonel Belcher Care Centre 16 94 +0 St. Marguerite Manor 27 94 +1 Prince of Peace Manor 14 94 -2 AgeCare Sagewood 26 93 -1 Revera Heartland 22 93 -2 AgeCare Seton 77 93 -1 AgeCare Walden Heights 88 92 -2 Edgemont Retirement Residence 14 92 -1 Silver Willow Lodge 16 92 -5 Holy Cross Manor 27 92 -0 Whitehorn Village Retirement Community 19 92 -6 CALGARY ZONE AVERAGE --- 92 --- Eau Claire Retirement Residence 13 91 --- ALBERTA AVERAGE --- 91 --- Seasons Retirement High River 35 91 +1 Sage Hill Retirement Residence 14 91 --- Carewest Nickle House 6 91 -1 Strafford Foundation Tudor Manor 50 91 -6 Kingsland Terrace 16 91 +13 St. Teresa Place 54 90 --- Bethany Didsbury 34 90 -5 Wentworth Manor The Residence 17 89 -4 Scenic Acres Retirement Residence 9 89 -2 Millrise Place 13 87 -0 Swan Evergreen Village 12 85 --- Monterey Place 26 83 -6 2019 Results Change South Zone (N = 28 sites) from N Average 2016 Meadowlands Retirement Residence 5 98 +6 AgeCare Orchard Manor 8 98 +4 Cypress View Foundation Medicine Hat 25 96 -2 Good Samaritan Society Prairie Ridge 22 95 -0 Golden Acres Lodge 21 95 -1 Good Samaritan Society West Highlands 46 94 -1 Chinook Lodge 13 94 +0

APPENDIX VII 103

Table 3: Facility Environment (continued)

Clearview Lodge 14 94 -1 York Creek Lodge 7 93 +8 Masterpiece Southland Meadows 15 93 --- Sunny South Lodge 24 93 +3 Good Samaritan Society Lee Crest 28 93 +3 Meadow Ridge Seniors Village 13 93 +1 SOUTH ZONE AVERAGE --- 92 --- Good Samaritan Garden Vista 8 92 -3 AgeCare Sunrise Gardens 25 92 --- Good Samaritan Society Pincher Creek Vista Village 27 92 +6 River Ridge Seniors Village 9 92 -1 The Wellington Retirement Residence 27 91 +2 ALBERTA AVERAGE --- 91 --- Extendicare Fairmont Park 37 91 -0 Good Samaritan Society South Ridge Village 12 91 +2 Haven Care Centre 12 91 +3 St. Therese Villa 55 90 -0 Piyami Place 5 90 -3 Legacy Lodge 53 90 -5 Good Samaritan Society Park Meadows Village 31 90 -8 St. Michael's Health Centre 12 89 --- Good Samaritan Society Linden View 22 88 -2 AgeCare Columbia 25 87 -2 Note: Categorical decision rules based on the average extend beyond the first decimal place. In the event of a tie, sites are presented in order of their Overall Care Rating from highest to lowest.

APPENDIX VII 104

Dimension of Care: Resident Environment In 2019, the average Resident Environment score for the 145 eligible sites was 91 out of 100, and individual site averages ranged from 80 to 99 out of 100. Table 4 below summarizes the 2019 site-level Resident Environment averages and change in score from 2016 by AHS Zone (N = 145 sites). . When the Change from the 2016 survey is shaded GREEN this indicates that the 2019 score is statistically significantly HIGHER than the 2016 score.

. When the Change from the 2016 survey is shaded ORANGE this indicates that the 2019 score is statistically significantly LOWER than the 2016 score.

. No shade: 2019 and 2016 scores do not significantly differ. . “---" 2016 result unavailable.

Table 4: Resident Environment

2019 Results Change North Zone (N = 17 sites) from N Average 2016 Heimstaed Lodge 6 98 --- Shepherd's Care Barrhead 14 96 +7 Manoir du Lac 12 96 --- Vilna Lodge 10 96 --- Stone Brook 14 95 +3 Smithfield Lodge 12 95 +4 J.B. Wood Continuing Care Centre 6 94 --- Points West Living Cold Lake 6 92 --- Whispering Pines Seniors Lodge 5 92 --- Grande Prairie Care Centre 15 91 --- ALBERTA AVERAGE --- 91 --- NORTH ZONE AVERAGE --- 91 --- Mackenzie Place Supportive Living 31 90 --- Points West Living Slave Lake 6 90 --- Emerald Gardens Retirement Residence 9 89 -0 Prairie Lake Seniors Community 21 89 --- Hinton Continuing Care Centre 11 83 --- Points West Living Peace River 10 83 -4 Edson Healthcare Centre 6 81 ---

APPENDIX VII 105

Table 4: Resident Environment (continued)

2019 Results Change Edmonton Zone (N = 36 sites) from N Average 2016 Shepherd's Garden 17 98 +2 Our Parents' Home 5 97 --- Chartwell Wild Rose Retirement Residence 5 95 -0 Good Samaritan Society George Hennig Place 20 95 +4 Glastonbury Village (Mews) 21 94 -2 Shepherd's Care Vanguard 10 94 --- CapitalCare Laurier House Strathcona 27 94 -3 Laurel Heights Retirement Residence 32 94 +2 Garneau Hall 9 93 +2 Good Samaritan Society Spruce Grove Centre 13 93 -4 Tuoi Hac - Golden Age Manor 28 93 -0 Devonshire Manor 27 93 -1 Citadel Mews West 33 92 -4 Chartwell Aspen House 14 92 -1 Shepherds Care Kensington 22 92 +5 Lifestyle Options Whitemud 12 92 +2 Sprucewood Place 21 91 +10 Riverbend Retirement Residence 11 91 +4 ALBERTA AVERAGE --- 91 --- EDMONTON ZONE AVERAGE --- 91 --- Chateau Vitaline 12 91 -5 CapitalCare Dickinsfield 9 90 --- CapitalCare Laurier House Lynnwood 39 90 -4 Lifestyle Options - Terra Losa 15 90 -3 Copper Sky Lodge 54 90 -2 Chartwell Country Cottage Retirement Residence 11 90 -2 Chartwell St. Albert 22 90 +2 St. Albert Retirement Residence 11 89 --- Rutherford Heights Retirement Residence 24 88 --- Grand Manor 21 88 --- Rosedale Estates 21 87 -3 Saint Thomas Health Centre 36 87 -3 Emmanuel Home 6 87 -8 Salvation Army Grace Manor 30 87 +0 Summerwood Village Retirement Residence 7 87 -9 Villa Marguerite 52 86 +7 Good Samaritan Society Wedman House 17 86 -8 Chartwell Griesbach 26 85 -7

APPENDIX VII 106

Table 4: Resident Environment (continued)

2019 Results Change Central Zone (N = 36 sites) from N Average 2016 Vermilion Valley Lodge 14 99 +9 Bashaw Meadows 15 96 +3 Wetaskiwin Meadows 14 96 -2 Coronation Hospital and Care Centre 10 95 +4 Royal Oak Manor 27 94 +3 Pioneer House 10 94 --- Islay Assisted Living 12 93 -3 Sundre Seniors Supportive Living 6 93 --- West Park Lodge 13 93 -3 Seasons Retirement Ponoka 12 93 -2 Hillview Lodge 18 92 --- Eckville Manor House 11 92 --- Points West Living Wainwright 14 92 -4 Seasons Retirement Camrose 15 92 -3 Bethany Meadows 20 92 --- Points West Living Stettler 29 92 +0 Heritage House 12 92 +2 Clearwater Centre 18 91 -1 ALBERTA AVERAGE --- 91 --- Seasons Drayton Valley 10 91 +9 Seasons Retirement Olds 13 91 +1 CENTRAL ZONE AVERAGE --- 91 --- Extendicare Michener Hill 16 91 +0 Providence Place 6 91 -2 Faith House 7 90 --- Vegreville Manor 6 90 +1 Century Park 6 90 --- Points West Living Red Deer 21 90 --- Points West Living Lloydminster 12 89 --- Seasons Retirement Wetaskiwin 7 89 -4 Park Avenue At Creekside 8 89 --- Bethany Sylvan Lake 13 88 -11 Seasons Encore Olds 15 88 --- Timberstone Mews 20 86 --- Sunset Manor 21 86 -6 Good Samaritan Good Shepherd Lutheran Home 26 86 -3 Viewpoint 13 84 -5 Villa Marie 39 80 -7

APPENDIX VII 107

Table 4: Resident Environment (continued)

2019 Results Change Calgary Zone (N = 28 sites) from N Average 2016 Prince of Peace Manor 14 96 +2 Revera Heartland 22 95 +2 Evanston Grand Village 25 94 -1 Carewest Colonel Belcher Care Centre 16 94 +0 Scenic Acres Retirement Residence 9 94 +3 Carewest Nickle House 6 93 +1 St. Marguerite Manor 27 93 -0 Strafford Foundation Tudor Manor 50 93 -3 McKenzie Towne Retirement Residence 12 93 -4 AgeCare Walden Heights 90 93 +2 Bethany Didsbury 34 93 -1 AgeCare Sagewood 26 92 +0 Swan Evergreen Village 12 92 --- Holy Cross Manor 27 92 +2 Providence Care Centre 15 92 --- Wentworth Manor The Residence 17 91 -2 Edgemont Retirement Residence 14 91 -0 CALGARY ZONE AVERAGE --- 91 --- ALBERTA AVERAGE --- 91 --- Kingsland Terrace 16 91 +12 Whitehorn Village Retirement Community 19 91 -4 St. Teresa Place 55 91 --- AgeCare Seton 78 89 -3 Sage Hill Retirement Residence 15 89 --- Seasons Retirement High River 36 89 -2 Silver Willow Lodge 16 89 -5 Eau Claire Retirement Residence 13 87 --- Monterey Place 26 86 -4 Aspen Ridge Lodge 9 86 -8 Millrise Place 13 85 -3 2019 Results Change South Zone (N = 28 sites) from N Average 2016 Chinook Lodge 13 98 +6 AgeCare Orchard Manor 8 97 +2 The Wellington Retirement Residence 27 96 +3 Meadowlands Retirement Residence 6 96 +9 Sunny South Lodge 24 95 +1 Clearview Lodge 14 93 +2 AgeCare Sunrise Gardens 25 93 ---

APPENDIX VII 108

Table 4: Resident Environment (continued)

Good Samaritan Society Pincher Creek Vista Village 27 93 +1 Meadow Ridge Seniors Village 13 93 -2 Golden Acres Lodge 21 93 -3 Good Samaritan Society West Highlands 46 93 -1 Cypress View Foundation Medicine Hat 25 92 -2 Good Samaritan Garden Vista 8 92 -5 Good Samaritan Society Prairie Ridge 22 92 -2 Haven Care Centre 12 92 +4 SOUTH ZONE AVERAGE --- 92 --- Extendicare Fairmont Park 37 91 +1 ALBERTA AVERAGE --- 91 --- Masterpiece Southland Meadows 18 91 --- Good Samaritan Society South Ridge Village 13 91 -4 AgeCare Columbia 25 91 +2 Legacy Lodge 53 90 -4 York Creek Lodge 7 90 +7 Good Samaritan Society Lee Crest 27 90 +2 River Ridge Seniors Village 9 90 -4 Good Samaritan Society Linden View 22 89 -5 Good Samaritan Society Park Meadows Village 31 89 -5 St. Therese Villa 57 88 -1 Piyami Place 4 88 -8 St. Michael's Health Centre 12 88 --- Note: Categorical decision rules based on the average extend beyond the first decimal place. In the event of a tie, sites are presented in order of their Overall Care Rating from highest to lowest.

APPENDIX VII 109

Dimension of Care: Choice In 2019, the average Choice score for the 145 eligible sites was 91 out of 100 and individual site averages ranged from 74 to 98 out of 100. Table 5 below summarizes the 2019 site-level Choice averages and change in score from 2016 by AHS Zone (N = 145 sites). . When the Change from the 2016 survey is shaded GREEN this indicates that the 2019 score is statistically significantly HIGHER than the 2016 score.

. When the Change from the 2016 survey is shaded ORANGE this indicates that the 2019 score is statistically significantly LOWER than the 2016 score.

. No shade: 2019 and 2016 scores do not significantly differ. . “---" 2016 result unavailable.

Table 5: Choice

2019 Results Change North Zone (N = 17 sites) from N Average 2016 Heimstaed Lodge 6 98 --- Manoir du Lac 11 97 --- Shepherd's Care Barrhead 12 96 +9 Stone Brook 14 95 +7 Vilna Lodge 10 95 --- Whispering Pines Seniors Lodge 5 94 --- Points West Living Slave Lake 6 93 --- Mackenzie Place Supportive Living 30 91 --- NORTH ZONE AVERAGE --- 91 --- Points West Living Peace River 10 91 -1 ALBERTA AVERAGE --- 91 --- Points West Living Cold Lake 6 90 --- Emerald Gardens Retirement Residence 10 90 +0 Smithfield Lodge 12 88 -2 Grande Prairie Care Centre 15 88 --- Hinton Continuing Care Centre 11 88 --- Prairie Lake Seniors Community 20 88 --- J.B. Wood Continuing Care Centre 7 85 --- Edson Healthcare Centre 6 82 --- 2019 Results Change Edmonton Zone (N = 36 sites) from N Average 2016 Lifestyle Options Whitemud 12 97 +6 Our Parents' Home 5 96 --- Shepherd's Care Vanguard 10 96 --- Garneau Hall 9 96 +0

APPENDIX VII 110

Table 5: Choice (continued)

Emmanuel Home 6 95 +0 Shepherd's Garden 17 95 -1 Good Samaritan Society George Hennig Place 20 95 +3 Riverbend Retirement Residence 11 94 +1 CapitalCare Dickinsfield 9 94 --- Good Samaritan Society Wedman House 17 94 +2 Chartwell Aspen House 14 93 +2 Chartwell Wild Rose Retirement Residence 5 93 +3 Lifestyle Options - Terra Losa 15 92 -1 Chartwell St. Albert 22 92 +2 St. Albert Retirement Residence 9 91 --- Copper Sky Lodge 53 91 +1 Good Samaritan Society Spruce Grove Centre 13 91 -1 Citadel Mews West 33 91 -4 Sprucewood Place 22 91 +2 ALBERTA AVERAGE --- 91 --- EDMONTON ZONE AVERAGE --- 91 --- Glastonbury Village (Mews) 21 90 +1 Villa Marguerite 51 90 +4 Rutherford Heights Retirement Residence 25 90 --- Tuoi Hac - Golden Age Manor 25 89 +0 Laurel Heights Retirement Residence 33 89 +1 Chateau Vitaline 12 89 -4 Chartwell Griesbach 26 89 -4 Shepherds Care Kensington 22 88 -2 Chartwell Country Cottage Retirement Residence 11 88 -4 Devonshire Manor 26 88 -3 CapitalCare Laurier House Strathcona 27 87 -2 Grand Manor 22 87 --- Saint Thomas Health Centre 34 87 -5 Summerwood Village Retirement Residence 7 85 -9 Rosedale Estates 21 84 -11 Salvation Army Grace Manor 29 83 -3 CapitalCare Laurier House Lynnwood 39 83 -8

APPENDIX VII 111

Table 5: Choice (continued)

2019 Results Change Central Zone (N = 36 sites) from N Average 2016 Seasons Retirement Ponoka 12 98 +3 Coronation Hospital and Care Centre 11 96 +3 Vermilion Valley Lodge 14 96 +6 Sundre Seniors Supportive Living 6 96 --- Century Park 6 95 --- Bethany Meadows 20 95 --- Points West Living Lloydminster 13 95 --- Hillview Lodge 18 94 --- Pioneer House 11 94 --- Vegreville Manor 6 92 +9 Eckville Manor House 11 92 --- Providence Place 6 92 -0 Royal Oak Manor 27 92 +10 Points West Living Wainwright 13 91 -4 Extendicare Michener Hill 16 91 +0 Wetaskiwin Meadows 14 91 +4 Seasons Retirement Olds 13 91 +10 Park Avenue At Creekside 7 91 --- Bashaw Meadows 15 91 -5 ALBERTA AVERAGE --- 91 --- Points West Living Stettler 29 91 +1 West Park Lodge 13 90 -1 Viewpoint 13 90 +6 CENTRAL ZONE AVERAGE --- 90 --- Seasons Drayton Valley 10 89 -1 Good Samaritan Good Shepherd Lutheran Home 28 89 -0 Heritage House 12 88 +2 Seasons Retirement Wetaskiwin 7 88 -3 Points West Living Red Deer 21 88 --- Bethany Sylvan Lake 13 87 -6 Seasons Encore Olds 15 87 --- Clearwater Centre 18 85 +1 Villa Marie 40 85 -5 Seasons Retirement Camrose 15 85 -4 Sunset Manor 21 84 -1 Timberstone Mews 20 84 --- Faith House 7 84 --- Islay Assisted Living 11 82 -10

APPENDIX VII 112

Table 5: Choice (continued)

2019 Results Change Calgary Zone (N = 28 sites) from N Average 2016 McKenzie Towne Retirement Residence 12 97 -1 Wentworth Manor The Residence 18 97 +1 Edgemont Retirement Residence 14 95 -1 Kingsland Terrace 16 95 +18 Prince of Peace Manor 14 94 +4 Carewest Colonel Belcher Care Centre 16 94 +2 Revera Heartland 22 93 -1 St. Marguerite Manor 26 93 +1 Scenic Acres Retirement Residence 9 92 +1 Evanston Grand Village 24 92 -1 Swan Evergreen Village 11 92 --- Providence Care Centre 14 92 --- Holy Cross Manor 27 92 +2 AgeCare Walden Heights 90 91 -1 Aspen Ridge Lodge 10 91 -3 AgeCare Seton 77 91 -0 CALGARY ZONE AVERAGE --- 91 --- Whitehorn Village Retirement Community 20 91 -5 AgeCare Sagewood 27 91 -1 ALBERTA AVERAGE --- 91 --- Bethany Didsbury 33 90 -1 Silver Willow Lodge 16 90 +0 Strafford Foundation Tudor Manor 50 90 +1 St. Teresa Place 55 89 --- Sage Hill Retirement Residence 15 89 --- Monterey Place 26 88 -3 Seasons Retirement High River 35 88 -4 Millrise Place 14 86 -1 Eau Claire Retirement Residence 13 85 --- Carewest Nickle House 6 85 +1 2019 Results Change South Zone (N = 28 sites) from N Average 2016 AgeCare Orchard Manor 8 97 +3 Chinook Lodge 12 95 +3 Meadow Ridge Seniors Village 13 94 +2 Cypress View Foundation Medicine Hat 25 94 -1 Good Samaritan Society Prairie Ridge 21 94 -1 AgeCare Columbia 24 94 +4 Sunny South Lodge 23 94 +3

APPENDIX VII 113

Table 5: Choice (continued)

Good Samaritan Garden Vista 7 93 -1 Haven Care Centre 12 93 +6 Good Samaritan Society West Highlands 46 93 -1 Clearview Lodge 14 92 -4 Golden Acres Lodge 22 92 -3 Good Samaritan Society South Ridge Village 13 91 +1 ALBERTA AVERAGE --- 91 --- Masterpiece Southland Meadows 18 91 --- Good Samaritan Society Lee Crest 28 90 +3 SOUTH ZONE AVERAGE --- 90 --- Good Samaritan Society Park Meadows Village 31 90 -2 York Creek Lodge 7 90 -2 Legacy Lodge 53 89 -3 Extendicare Fairmont Park 37 89 +2 The Wellington Retirement Residence 27 89 -2 Meadowlands Retirement Residence 6 89 +13 Good Samaritan Society Pincher Creek Vista Village 27 89 -3 River Ridge Seniors Village 9 89 -2 St. Michael's Health Centre 12 88 --- St. Therese Villa 55 88 -3 Good Samaritan Society Linden View 22 87 -4 AgeCare Sunrise Gardens 25 83 --- Piyami Place 5 74 -20 Note: Categorical decision rules based on the average extend beyond the first decimal place. In the event of a tie, sites are presented in order of their Overall Care Rating from highest to lowest. The 2016 site average for the Dimension of Care Choice is different than in the 2016 report due to a previous error in the calculation of this score. This does not affect the site rankings by AHS Zone.

APPENDIX VII 114

Dimension of Care: Relationship with Employees In 2019, the average Relationship with Employees score for the 145 eligible sites was 91 out of 100, and individual site averages ranged from 76 to 100 out of 100. Table 6 below summarizes the 2019 site-level Relationship with Employees averages and change in score from 2016 by AHS Zone (N = 145 sites). . When the Change from the 2016 survey is shaded GREEN this indicates that the 2019 score is statistically significantly HIGHER than the 2016 score.

. When the Change from the 2016 survey is shaded ORANGE this indicates that the 2019 score is statistically significantly LOWER than the 2016 score.

. No shade: 2019 and 2016 scores do not significantly differ. . “---" 2016 result unavailable.

Table 6: Relationship with Employees

2019 Results Change North Zone (N = 17 sites) from N Average 2016 Heimstaed Lodge 6 99 --- Manoir du Lac 12 97 --- Shepherd's Care Barrhead 14 97 +10 Stone Brook 14 97 +3 Smithfield Lodge 12 94 +0 Points West Living Peace River 10 93 +2 Mackenzie Place Supportive Living 31 92 --- Vilna Lodge 10 92 --- Prairie Lake Seniors Community 21 91 --- Points West Living Cold Lake 6 91 --- ALBERTA AVERAGE --- 91 --- NORTH ZONE AVERAGE --- 90 --- Points West Living Slave Lake 6 89 --- Emerald Gardens Retirement Residence 10 88 -4 Grande Prairie Care Centre 15 87 --- J.B. Wood Continuing Care Centre 7 84 --- Edson Healthcare Centre 6 84 --- Hinton Continuing Care Centre 11 83 --- Whispering Pines Seniors Lodge 5 80 --- 2019 Results Change Edmonton Zone (N = 36 sites) from N Average 2016 Citadel Mews West 33 96 -0 Lifestyle Options Whitemud 12 95 +8 Shepherd's Care Vanguard 10 95 --- Our Parents' Home 5 95 ---

APPENDIX VII 115

Table 6: Relationship with Employees (continued)

Garneau Hall 9 94 -4 St. Albert Retirement Residence 11 94 --- Good Samaritan Society George Hennig Place 20 94 +1 Shepherd's Garden 17 94 +2 CapitalCare Dickinsfield 9 93 --- Good Samaritan Society Spruce Grove Centre 13 92 -5 Chartwell Wild Rose Retirement Residence 5 92 +2 Glastonbury Village (Mews) 21 91 -2 Emmanuel Home 6 91 -5 ALBERTA AVERAGE --- 91 --- Riverbend Retirement Residence 11 91 -4 Lifestyle Options - Terra Losa 15 91 -7 Devonshire Manor 27 91 -3 Rosedale Estates 21 90 -4 Chartwell St. Albert 22 90 +0 Chartwell Griesbach 24 90 -4 CapitalCare Laurier House Strathcona 27 90 -5 EDMONTON ZONE AVERAGE --- 90 --- Copper Sky Lodge 54 89 +1 Laurel Heights Retirement Residence 34 89 -6 Chartwell Aspen House 14 89 -3 Shepherds Care Kensington 22 89 -2 Good Samaritan Society Wedman House 17 89 -1 Chateau Vitaline 12 88 +1 Chartwell Country Cottage Retirement Residence 11 87 -7 Grand Manor 21 87 --- Tuoi Hac - Golden Age Manor 28 86 -4 Saint Thomas Health Centre 36 86 -6 Villa Marguerite 49 85 +5 CapitalCare Laurier House Lynnwood 39 84 -7 Rutherford Heights Retirement Residence 25 84 --- Sprucewood Place 21 84 -1 Summerwood Village Retirement Residence 7 82 -12 Salvation Army Grace Manor 29 81 -7

APPENDIX VII 116

Table 6: Relationship with Employees (continued)

2019 Results Change Central Zone (N = 36 sites) from N Average 2016 Vermilion Valley Lodge 14 100 +5 Seasons Retirement Wetaskiwin 7 96 -3 Wetaskiwin Meadows 14 96 -1 Seasons Retirement Olds 13 96 +5 Eckville Manor House 11 96 --- Vegreville Manor 6 96 +3 Royal Oak Manor 27 95 +7 Points West Living Lloydminster 12 95 --- Faith House 7 95 --- Coronation Hospital and Care Centre 11 95 -3 Points West Living Wainwright 14 95 -4 Bashaw Meadows 15 94 +1 Park Avenue At Creekside 8 94 --- Seasons Retirement Ponoka 12 94 +8 Sundre Seniors Supportive Living 6 93 --- Pioneer House 11 93 --- Hillview Lodge 18 93 --- Seasons Drayton Valley 9 92 +7 Heritage House 12 92 +5 Providence Place 6 92 -3 Bethany Sylvan Lake 13 91 -6 CENTRAL ZONE AVERAGE --- 91 --- ALBERTA AVERAGE --- 91 --- Seasons Retirement Camrose 15 90 -1 Bethany Meadows 20 90 --- Islay Assisted Living 12 89 -5 Timberstone Mews 20 89 --- Points West Living Stettler 29 88 -1 Sunset Manor 20 88 -2 Century Park 6 88 --- Points West Living Red Deer 21 87 --- Good Samaritan Good Shepherd Lutheran Home 28 87 +2 West Park Lodge 13 87 -8 Villa Marie 40 86 -1 Viewpoint 13 84 -8 Clearwater Centre 18 83 -7 Extendicare Michener Hill 16 83 -10 Seasons Encore Olds 15 76 ---

APPENDIX VII 117

Table 6: Relationship with Employees (continued)

2019 Results Change Calgary Zone (N = 28 sites) from N Average 2016 Prince of Peace Manor 14 96 +3 McKenzie Towne Retirement Residence 12 96 -4 Providence Care Centre 15 95 --- Carewest Colonel Belcher Care Centre 16 94 +7 Revera Heartland 22 94 -3 AgeCare Walden Heights 88 94 +3 Aspen Ridge Lodge 10 94 -4 Swan Evergreen Village 12 93 --- AgeCare Sagewood 28 93 +0 Bethany Didsbury 33 93 -2 Kingsland Terrace 16 93 +12 Whitehorn Village Retirement Community 20 92 -4 AgeCare Seton 77 92 -1 Edgemont Retirement Residence 14 92 -1 Strafford Foundation Tudor Manor 50 91 -0 Scenic Acres Retirement Residence 9 91 -2 CALGARY ZONE AVERAGE --- 91 --- Wentworth Manor The Residence 17 91 +0 St. Teresa Place 55 91 --- ALBERTA AVERAGE --- 91 --- Holy Cross Manor 27 91 +1 St. Marguerite Manor 27 90 -4 Silver Willow Lodge 16 90 -7 Millrise Place 13 89 -1 Sage Hill Retirement Residence 15 89 --- Seasons Retirement High River 36 88 -2 Eau Claire Retirement Residence 13 88 --- Evanston Grand Village 25 87 -5 Monterey Place 26 86 -6 Carewest Nickle House 6 84 -4 2019 Results Change South Zone (N = 28 sites) from N Average 2016 AgeCare Orchard Manor 7 100 +4 Chinook Lodge 13 98 +6 York Creek Lodge 7 95 +0 Cypress View Foundation Medicine Hat 24 95 +3 Good Samaritan Society Prairie Ridge 22 95 +0 Meadowlands Retirement Residence 6 94 +5 Sunny South Lodge 24 94 +1

APPENDIX VII 118

Table 6: Relationship with Employees (continued)

Masterpiece Southland Meadows 18 94 --- Good Samaritan Society West Highlands 46 94 -1 AgeCare Columbia 25 94 +2 Good Samaritan Society Pincher Creek Vista Village 27 94 +2 Golden Acres Lodge 22 94 -4 Clearview Lodge 14 92 -4 River Ridge Seniors Village 9 92 -3 Good Samaritan Garden Vista 8 92 -3 SOUTH ZONE AVERAGE --- 91 --- Haven Care Centre 12 91 +2 The Wellington Retirement Residence 26 91 -4 Extendicare Fairmont Park 37 91 +3 ALBERTA AVERAGE --- 91 --- Good Samaritan Society Lee Crest 27 90 +2 Good Samaritan Society Park Meadows Village 31 89 -5 St. Michael's Health Centre 12 89 --- Meadow Ridge Seniors Village 13 88 +0 Good Samaritan Society Linden View 22 88 -5 St. Therese Villa 57 88 +3 Good Samaritan Society South Ridge Village 12 87 -0 Legacy Lodge 53 87 -6 AgeCare Sunrise Gardens 25 85 --- Piyami Place 5 82 -11 Note: Categorical decision rules based on the average extend beyond the first decimal place. In the event of a tie, sites are presented in order of their Overall Care Rating from highest to lowest.

APPENDIX VII 119

Dimension of Care: Activities In 2019, the average Activities score for the 145 eligible sites was 80 out of 100, and individual site averages ranged from 49 to 98 out of 100. Table 7 below summarizes the 2019 site-level Activities averages and change in score from 2016 by AHS Zone (N = 145 sites). . When the Change from the 2016 survey is shaded GREEN this indicates that the 2019 score is statistically significantly HIGHER than the 2016 score.

. When the Change from the 2016 survey is shaded ORANGE this indicates that the 2019 score is statistically significantly LOWER than the 2016 score.

. No shade: 2019 and 2016 scores do not significantly differ. . “---" 2016 result unavailable.

Table 7: Activities

2019 Results Change North Zone (N = 17 sites) from N Average 2016 Heimstaed Lodge 6 98 --- Manoir du Lac 11 89 --- Vilna Lodge 10 89 --- Stone Brook 14 85 +5 Smithfield Lodge 12 84 +1 Whispering Pines Seniors Lodge 5 83 --- Shepherd's Care Barrhead 14 82 +7 Points West Living Slave Lake 6 81 --- ALBERTA AVERAGE --- 80 --- NORTH ZONE AVERAGE --- 78 --- Emerald Gardens Retirement Residence 10 77 +4 Prairie Lake Seniors Community 18 77 --- Mackenzie Place Supportive Living 29 76 --- Grande Prairie Care Centre 14 73 --- Edson Healthcare Centre 6 71 --- Points West Living Peace River 10 70 +1 Hinton Continuing Care Centre 11 70 --- Points West Living Cold Lake 6 64 --- J.B. Wood Continuing Care Centre 6 49 ---

APPENDIX VII 120

Table 7: Activities (continued)

2019 Results Change Edmonton Zone (N = 36 sites) from N Average 2016 Grand Manor 21 91 --- Emmanuel Home 6 89 +6 St. Albert Retirement Residence 10 88 --- Chartwell Wild Rose Retirement Residence 5 88 -1 Chartwell Country Cottage Retirement Residence 11 87 +4 CapitalCare Dickinsfield 9 87 --- Citadel Mews West 33 87 +2 Sprucewood Place 22 86 +10 Glastonbury Village (Mews) 21 86 +4 Lifestyle Options - Terra Losa 15 86 +2 Good Samaritan Society Spruce Grove Centre 12 86 -0 Chartwell Aspen House 14 84 +4 Good Samaritan Society George Hennig Place 19 84 +5 Riverbend Retirement Residence 11 84 +0 Shepherds Care Kensington 21 83 +1 Copper Sky Lodge 54 83 +7 Salvation Army Grace Manor 30 83 -1 Shepherd's Care Vanguard 10 82 --- Laurel Heights Retirement Residence 32 82 +4 Chartwell Griesbach 26 82 -5 Tuoi Hac - Golden Age Manor 25 82 +4 EDMONTON ZONE AVERAGE --- 81 --- Lifestyle Options Whitemud 11 81 +4 CapitalCare Laurier House Strathcona 27 81 +3 Chateau Vitaline 12 80 +8 ALBERTA AVERAGE --- 80 --- Chartwell St. Albert 21 79 -4 Rutherford Heights Retirement Residence 25 79 --- Devonshire Manor 27 79 -8 Shepherd's Garden 16 79 -7 Villa Marguerite 49 78 +8 Saint Thomas Health Centre 32 76 +2 CapitalCare Laurier House Lynnwood 37 74 -9 Summerwood Village Retirement Residence 7 74 -19 Rosedale Estates 21 73 -12 Our Parents' Home 5 72 --- Garneau Hall 7 72 -10 Good Samaritan Society Wedman House 15 66 -17

APPENDIX VII 121

Table 7: Activities (continued)

2019 Results Change Central Zone (N = 36 sites) from N Average 2016 Providence Place 6 91 +4 Royal Oak Manor 27 88 +13 Points West Living Lloydminster 12 86 --- Coronation Hospital and Care Centre 11 85 +2 Seasons Retirement Ponoka 8 85 -9 Points West Living Wainwright 13 84 +2 Eckville Manor House 11 84 --- Pioneer House 11 84 --- Hillview Lodge 18 83 --- Bashaw Meadows 15 82 -1 Extendicare Michener Hill 16 82 +2 Vegreville Manor 6 82 +5 Heritage House 12 81 +15 Seasons Retirement Wetaskiwin 6 81 -6 Sundre Seniors Supportive Living 6 81 --- Good Samaritan Good Shepherd Lutheran Home 27 81 +6 Vermilion Valley Lodge 14 81 +12 Sunset Manor 20 80 -1 Bethany Meadows 20 80 --- ALBERTA AVERAGE --- 80 --- Park Avenue At Creekside 8 80 --- Seasons Drayton Valley 10 79 +8 Islay Assisted Living 12 78 -7 Century Park 6 78 --- CENTRAL ZONE AVERAGE --- 77 --- Points West Living Red Deer 17 75 --- Seasons Retirement Olds 12 74 +2 Wetaskiwin Meadows 14 74 +3 Seasons Retirement Camrose 15 72 -10 West Park Lodge 13 71 -14 Points West Living Stettler 28 70 -3 Villa Marie 27 66 -7 Seasons Encore Olds 14 65 --- Timberstone Mews 20 65 --- Viewpoint 13 62 -5 Faith House 6 61 --- Bethany Sylvan Lake 13 60 -12 Clearwater Centre 18 57 -12

APPENDIX VII 122

Table 7: Activities (continued)

2019 Results Change Calgary Zone (N = 28 sites) from N Average 2016 Edgemont Retirement Residence 14 92 +4 Prince of Peace Manor 13 88 +3 Revera Heartland 21 88 +1 McKenzie Towne Retirement Residence 12 88 -2 AgeCare Sagewood 25 87 +3 Providence Care Centre 13 84 --- Strafford Foundation Tudor Manor 46 84 +1 Whitehorn Village Retirement Community 20 84 -6 Carewest Colonel Belcher Care Centre 16 83 -3 Wentworth Manor The Residence 18 82 -5 St. Marguerite Manor 25 82 -1 Monterey Place 25 81 +0 Swan Evergreen Village 12 81 --- Sage Hill Retirement Residence 14 81 --- Aspen Ridge Lodge 10 81 -14 Holy Cross Manor 26 81 +5 AgeCare Seton 74 80 -2 Evanston Grand Village 23 80 +0 Scenic Acres Retirement Residence 9 80 -5 CALGARY ZONE AVERAGE --- 80 --- ALBERTA AVERAGE --- 80 --- Kingsland Terrace 16 79 +7 AgeCare Walden Heights 88 78 -4 Seasons Retirement High River 36 76 -6 Eau Claire Retirement Residence 13 76 --- Bethany Didsbury 33 74 -8 St. Teresa Place 52 73 --- Millrise Place 12 73 -7 Silver Willow Lodge 16 72 -10 Carewest Nickle House 6 52 -35 2019 Results Change South Zone (N = 28 sites) from N Average 2016 Meadowlands Retirement Residence 6 95 +20 AgeCare Orchard Manor 8 91 +7 Haven Care Centre 12 89 +6 Good Samaritan Society West Highlands 45 87 +1 Good Samaritan Garden Vista 7 86 -5 Sunny South Lodge 23 86 +4 Cypress View Foundation Medicine Hat 24 86 -4

APPENDIX VII 123

Table 7: Activities (continued)

Good Samaritan Society Prairie Ridge 22 86 -6 Clearview Lodge 14 86 -5 Masterpiece Southland Meadows 18 84 --- Chinook Lodge 13 83 -5 Good Samaritan Society Pincher Creek Vista Village 27 83 -3 York Creek Lodge 7 82 -2 SOUTH ZONE AVERAGE --- 81 --- River Ridge Seniors Village 9 81 +3 Golden Acres Lodge 22 81 -11 St. Therese Villa 55 80 -1 ALBERTA AVERAGE --- 80 --- Good Samaritan Society South Ridge Village 13 79 -2 Legacy Lodge 53 78 -8 AgeCare Columbia 23 77 -1 Good Samaritan Society Park Meadows Village 31 77 -4 Meadow Ridge Seniors Village 13 76 +4 AgeCare Sunrise Gardens 25 76 --- Extendicare Fairmont Park 37 76 +2 The Wellington Retirement Residence 25 76 -5 Good Samaritan Society Lee Crest 28 75 -1 Good Samaritan Society Linden View 22 73 -6 Piyami Place 5 71 -13 St. Michael's Health Centre 12 69 --- Note: Categorical decision rules based on the average extend beyond the first decimal place. In the event of a tie, sites are presented in order of their Overall Care Rating from highest to lowest.

APPENDIX VII 124

Dimension of Care: Meals and Dining In 2019, the average Meals and Dining score for the 145 eligible sites was 79 out of 100, and individual site averages ranged from 54 to 96 out of 100. Table 8 below summarizes the 2019 site-level Meals and Dining averages and change in score from 2016 by AHS Zone (N = 145 sites). . When the Change from the 2016 survey is shaded GREEN this indicates that the 2019 score is statistically significantly HIGHER than the 2016 score.

. When the Change from the 2016 survey is shaded ORANGE this indicates that the 2019 score is statistically significantly LOWER than the 2016 score.

. No shade: 2019 and 2016 scores do not significantly differ. . “---" 2016 result unavailable.

Table 8: Meals and Dining

2019 Results Change North Zone (N = 17 sites) from N Average 2016 Vilna Lodge 10 91 --- Heimstaed Lodge 5 90 --- Shepherd's Care Barrhead 14 90 +18 Manoir du Lac 12 88 --- Whispering Pines Seniors Lodge 5 87 --- Stone Brook 14 84 +12 Points West Living Slave Lake 6 82 --- Prairie Lake Seniors Community 20 82 --- Emerald Gardens Retirement Residence 9 80 -6 Smithfield Lodge 12 80 +1 NORTH ZONE AVERAGE --- 79 --- ALBERTA AVERAGE --- 79 --- Edson Healthcare Centre 6 78 --- Hinton Continuing Care Centre 11 76 --- Grande Prairie Care Centre 15 74 --- Mackenzie Place Supportive Living 31 71 --- Points West Living Peace River 10 70 +5 Points West Living Cold Lake 6 68 --- J.B. Wood Continuing Care Centre 7 57 ---

APPENDIX VII 125

Table 8: Meals and Dining (continued)

2019 Results Change Edmonton Zone (N = 36 sites) from N Average 2016 Good Samaritan Society Spruce Grove Centre 13 96 +5 CapitalCare Dickinsfield 9 92 --- Good Samaritan Society George Hennig Place 20 87 +5 Grand Manor 22 87 --- Chartwell Country Cottage Retirement Residence 11 87 +1 Emmanuel Home 6 86 -2 Lifestyle Options - Terra Losa 14 83 -3 Chartwell Wild Rose Retirement Residence 5 83 +4 Our Parents' Home 5 82 --- Shepherd's Garden 17 82 +15 Sprucewood Place 20 82 +4 Rutherford Heights Retirement Residence 24 81 --- Riverbend Retirement Residence 11 79 -4 EDMONTON ZONE AVERAGE --- 79 --- St. Albert Retirement Residence 11 79 --- Lifestyle Options Whitemud 12 79 +4 ALBERTA AVERAGE --- 79 --- Summerwood Village Retirement Residence 7 79 +1 Citadel Mews West 33 78 -1 Glastonbury Village (Mews) 21 78 +1 Rosedale Estates 21 77 -8 Copper Sky Lodge 53 77 +5 Salvation Army Grace Manor 30 77 +1 Chartwell Griesbach 26 77 -2 Laurel Heights Retirement Residence 34 77 +8 Chartwell Aspen House 14 77 -4 Good Samaritan Society Wedman House 17 77 -0 Chartwell St. Albert 22 76 -4 CapitalCare Laurier House Lynnwood 38 76 +5 CapitalCare Laurier House Strathcona 27 76 +4 Tuoi Hac - Golden Age Manor 27 76 +2 Chateau Vitaline 12 75 -8 Garneau Hall 9 75 -1 Villa Marguerite 52 74 +5 Devonshire Manor 25 73 -5 Shepherds Care Kensington 21 73 -1 Shepherd's Care Vanguard 10 73 --- Saint Thomas Health Centre 36 70 -2

APPENDIX VII 126

Table 8: Meals and Dining (continued)

2019 Results Change Central Zone (N = 36 sites) from N Average 2016 Eckville Manor House 11 94 --- Bashaw Meadows 15 89 +21 Faith House 7 89 --- Vegreville Manor 5 87 +15 Seasons Retirement Olds 13 86 +5 West Park Lodge 12 86 -0 Vermilion Valley Lodge 14 85 +4 Points West Living Lloydminster 12 85 --- Century Park 6 83 --- Pioneer House 11 83 --- Islay Assisted Living 12 81 -8 Wetaskiwin Meadows 14 81 -6 Providence Place 6 80 -11 Hillview Lodge 18 80 --- Viewpoint 13 80 +3 Seasons Retirement Wetaskiwin 7 80 -4 Points West Living Red Deer 21 80 --- Extendicare Michener Hill 15 79 +1 ALBERTA AVERAGE --- 79 --- CENTRAL ZONE AVERAGE --- 78 --- Sundre Seniors Supportive Living 6 78 --- Points West Living Stettler 29 78 -4 Clearwater Centre 18 78 -2 Coronation Hospital and Care Centre 11 77 -2 Heritage House 12 76 +11 Park Avenue At Creekside 8 76 --- Timberstone Mews 20 75 --- Points West Living Wainwright 14 74 -14 Good Samaritan Good Shepherd Lutheran Home 28 74 -1 Bethany Sylvan Lake 13 73 -7 Royal Oak Manor 27 72 +13 Bethany Meadows 20 72 --- Seasons Retirement Camrose 15 71 -6 Sunset Manor 21 70 -3 Seasons Encore Olds 15 69 --- Villa Marie 39 68 -6 Seasons Drayton Valley 9 65 -9 Seasons Retirement Ponoka 12 63 -15

APPENDIX VII 127

Table 8: Meals and Dining (continued)

2019 Results Change Calgary Zone (N = 28 sites) from N Average 2016 Carewest Nickle House 5 94 +7 Carewest Colonel Belcher Care Centre 16 89 +3 Prince of Peace Manor 14 86 +2 Wentworth Manor The Residence 18 84 +8 Kingsland Terrace 15 83 +22 Scenic Acres Retirement Residence 9 83 -4 Swan Evergreen Village 12 83 --- Revera Heartland 22 82 -3 Aspen Ridge Lodge 10 82 -6 Edgemont Retirement Residence 14 81 -2 Whitehorn Village Retirement Community 20 80 -4 ALBERTA AVERAGE --- 79 --- Evanston Grand Village 25 77 -3 AgeCare Sagewood 28 77 +5 Providence Care Centre 15 77 --- CALGARY ZONE AVERAGE --- 77 --- Bethany Didsbury 34 77 +1 Strafford Foundation Tudor Manor 50 76 +1 AgeCare Seton 78 75 -3 Sage Hill Retirement Residence 14 75 --- Monterey Place 25 74 -7 McKenzie Towne Retirement Residence 12 74 -16 Silver Willow Lodge 15 73 -9 Holy Cross Manor 27 73 +7 St. Marguerite Manor 26 73 -2 Seasons Retirement High River 36 73 -2 Eau Claire Retirement Residence 13 72 --- AgeCare Walden Heights 90 71 -4 St. Teresa Place 56 65 --- Millrise Place 13 54 -15 2019 Results Change South Zone (N = 28 sites) from N Average 2016 AgeCare Orchard Manor 8 94 +22 Clearview Lodge 14 91 +3 Good Samaritan Society Pincher Creek Vista Village 26 87 +4 Sunny South Lodge 23 86 +6 Good Samaritan Society Prairie Ridge 22 85 +8 Meadowlands Retirement Residence 6 85 +3 Golden Acres Lodge 22 85 -7

APPENDIX VII 128

Table 8: Meals and Dining (continued)

Masterpiece Southland Meadows 17 84 --- Good Samaritan Society West Highlands 46 84 +5 Cypress View Foundation Medicine Hat 24 83 -2 Good Samaritan Garden Vista 8 82 -7 York Creek Lodge 7 80 -8 SOUTH ZONE AVERAGE --- 80 --- Chinook Lodge 13 79 -5 ALBERTA AVERAGE --- 79 --- AgeCare Sunrise Gardens 25 78 --- AgeCare Columbia 25 78 +6 Haven Care Centre 12 77 +2 St. Therese Villa 57 77 +2 Piyami Place 5 76 -14 Good Samaritan Society Park Meadows Village 31 76 -5 The Wellington Retirement Residence 27 76 -9 Good Samaritan Society Lee Crest 28 76 +4 Meadow Ridge Seniors Village 13 76 -7 Legacy Lodge 52 75 -8 Good Samaritan Society Linden View 22 74 -2 Good Samaritan Society South Ridge Village 13 74 -6 Extendicare Fairmont Park 36 72 -3 River Ridge Seniors Village 9 72 -9 St. Michael's Health Centre 12 72 --- Note: Categorical decision rules based on the average extend beyond the first decimal place. In the event of a tie, sites are presented in order of their Overall Care Rating from highest to lowest.

APPENDIX VII 129

Dimension of Care: Communications In 2019, the average Communications score for the 145 eligible sites was 87 out of 100, and individual site averages ranged from 67 to 97 out of 100. Table 9 below summarizes the 2019 site-level Communications averages and change in score from 2016 by AHS Zone (N = 145 sites). . When the Change from the 2016 survey is shaded GREEN this indicates that the 2019 score is statistically significantly HIGHER than the 2016 score.

. When the Change from the 2016 survey is shaded ORANGE this indicates that the 2019 score is statistically significantly LOWER than the 2016 score.

. No shade: 2019 and 2016 scores do not significantly differ. . “---" 2016 result unavailable.

Table 9: Communications

2019 Results Change North Zone (N = 17 sites) from N Average 2016 Manoir du Lac 12 97 --- Vilna Lodge 10 96 --- Stone Brook 14 95 +12 Heimstaed Lodge 4 93 --- Mackenzie Place Supportive Living 30 92 --- Smithfield Lodge 12 91 +0 Shepherd's Care Barrhead 12 90 +11 Points West Living Peace River 10 89 -2 NORTH ZONE AVERAGE --- 88 --- Whispering Pines Seniors Lodge 5 87 --- ALBERTA AVERAGE --- 87 --- Points West Living Slave Lake 6 86 --- Prairie Lake Seniors Community 19 85 --- Emerald Gardens Retirement Residence 9 84 -5 Edson Healthcare Centre 5 84 --- J.B. Wood Continuing Care Centre 5 84 --- Grande Prairie Care Centre 15 83 --- Points West Living Cold Lake 6 82 --- Hinton Continuing Care Centre 11 80 ---

APPENDIX VII 130

Table 9: Communications (continued)

2019 Results Change Edmonton Zone (N = 36 sites) from N Average 2016 Chartwell Country Cottage Retirement Residence 11 96 +5 Lifestyle Options Whitemud 12 95 +13 Good Samaritan Society Spruce Grove Centre 12 93 +5 Chartwell Aspen House 14 93 -0 Emmanuel Home 6 93 +4 Glastonbury Village (Mews) 20 93 +6 Garneau Hall 7 92 +4 Shepherd's Garden 16 91 +5 Good Samaritan Society Wedman House 14 91 +3 St. Albert Retirement Residence 11 91 --- Summerwood Village Retirement Residence 5 90 +5 Sprucewood Place 21 90 +11 Good Samaritan Society George Hennig Place 19 90 +3 Grand Manor 20 89 --- Lifestyle Options - Terra Losa 12 88 -4 Copper Sky Lodge 52 88 +3 Tuoi Hac - Golden Age Manor 26 88 -1 Shepherd's Care Vanguard 9 88 --- Laurel Heights Retirement Residence 33 87 +0 Riverbend Retirement Residence 11 87 -0 ALBERTA AVERAGE --- 87 --- EDMONTON ZONE AVERAGE --- 87 --- Citadel Mews West 30 87 -3 Chateau Vitaline 11 86 -5 Rosedale Estates 21 85 -3 Chartwell Griesbach 24 85 -1 Rutherford Heights Retirement Residence 22 85 --- CapitalCare Dickinsfield 9 85 --- CapitalCare Laurier House Strathcona 25 84 -5 Saint Thomas Health Centre 36 84 +1 Chartwell St. Albert 20 83 +0 CapitalCare Laurier House Lynnwood 39 83 -0 Shepherds Care Kensington 19 83 -5 Devonshire Manor 25 82 -6 Salvation Army Grace Manor 28 82 +0 Chartwell Wild Rose Retirement Residence 5 79 -10 Villa Marguerite 49 78 +3 Our Parents' Home 5 67 ---

APPENDIX VII 131

Table 9: Communications (continued)

2019 Results Change Central Zone (N = 36 sites) from N Average 2016 Vermilion Valley Lodge 12 97 +7 Bashaw Meadows 15 95 +4 Eckville Manor House 11 94 --- Providence Place 6 94 -0 Faith House 6 93 --- Coronation Hospital and Care Centre 11 93 +2 Vegreville Manor 5 93 +5 Bethany Meadows 19 91 --- Points West Living Lloydminster 12 90 --- Hillview Lodge 18 90 --- Seasons Retirement Olds 12 89 +5 Sundre Seniors Supportive Living 6 89 --- Seasons Retirement Ponoka 12 89 +1 Royal Oak Manor 25 88 +6 Heritage House 12 88 +10 Points West Living Wainwright 13 87 -8 Seasons Retirement Camrose 15 87 +4 ALBERTA AVERAGE --- 87 --- Wetaskiwin Meadows 14 87 -3 Park Avenue At Creekside 8 87 --- Extendicare Michener Hill 13 87 +1 West Park Lodge 12 86 -8 CENTRAL ZONE AVERAGE --- 86 --- Pioneer House 11 85 --- Seasons Retirement Wetaskiwin 6 85 -10 Points West Living Stettler 28 83 -1 Viewpoint 13 82 -2 Points West Living Red Deer 21 82 --- Seasons Drayton Valley 10 82 +9 Bethany Sylvan Lake 13 82 -7 Clearwater Centre 18 82 -8 Islay Assisted Living 10 82 -11 Century Park 6 80 --- Timberstone Mews 18 78 --- Good Samaritan Good Shepherd Lutheran Home 25 78 +2 Seasons Encore Olds 15 77 --- Sunset Manor 18 76 -10 Villa Marie 28 73 -7

APPENDIX VII 132

Table 9: Communications (continued)

2019 Results Change Calgary Zone (N = 28 sites) from N Average 2016 Providence Care Centre 14 94 --- Scenic Acres Retirement Residence 9 94 +7 McKenzie Towne Retirement Residence 12 94 -3 Prince of Peace Manor 14 94 +5 Carewest Colonel Belcher Care Centre 15 92 -1 Edgemont Retirement Residence 11 91 -0 Kingsland Terrace 16 91 +31 Whitehorn Village Retirement Community 17 90 -0 Revera Heartland 22 88 -4 Evanston Grand Village 24 87 -2 CALGARY ZONE AVERAGE --- 87 --- ALBERTA AVERAGE --- 87 --- Bethany Didsbury 32 87 -0 Monterey Place 23 87 -3 Sage Hill Retirement Residence 13 86 --- Strafford Foundation Tudor Manor 47 86 +1 St. Marguerite Manor 27 86 -5 Aspen Ridge Lodge 10 86 -10 Wentworth Manor The Residence 18 86 -3 Seasons Retirement High River 34 86 +2 AgeCare Sagewood 27 86 -4 AgeCare Walden Heights 84 85 -1 Holy Cross Manor 27 85 -4 Eau Claire Retirement Residence 13 84 --- Carewest Nickle House 6 84 +1 St. Teresa Place 55 84 --- Swan Evergreen Village 11 84 --- Silver Willow Lodge 16 84 -8 AgeCare Seton 70 84 -6 Millrise Place 13 74 -12 2019 Results Change South Zone (N = 28 sites) from N Average 2016 Haven Care Centre 12 93 +2 Meadowlands Retirement Residence 6 93 +21 Golden Acres Lodge 21 93 +3 Clearview Lodge 14 92 -4 Good Samaritan Society Prairie Ridge 21 92 -0 Chinook Lodge 11 92 -2 Cypress View Foundation Medicine Hat 22 92 +3

APPENDIX VII 133

Table 9: Communications (continued)

Sunny South Lodge 23 91 +4 AgeCare Orchard Manor 8 91 +3 River Ridge Seniors Village 9 91 -3 Good Samaritan Society South Ridge Village 12 90 +8 Masterpiece Southland Meadows 18 90 --- Good Samaritan Society West Highlands 44 89 -3 Good Samaritan Society Pincher Creek Vista Village 27 89 -0 Good Samaritan Society Park Meadows Village 29 88 -1 Good Samaritan Garden Vista 8 87 -8 SOUTH ZONE AVERAGE --- 87 --- ALBERTA AVERAGE --- 87 --- York Creek Lodge 7 86 -5 The Wellington Retirement Residence 25 86 -6 Extendicare Fairmont Park 33 85 -1 Good Samaritan Society Lee Crest 28 85 +2 Good Samaritan Society Linden View 22 82 -12 St. Michael's Health Centre 11 82 --- Legacy Lodge 52 82 -10 AgeCare Columbia 23 82 -3 St. Therese Villa 52 81 -2 Meadow Ridge Seniors Village 13 80 -7 AgeCare Sunrise Gardens 22 80 --- Piyami Place 4 79 -9 Note: Categorical decision rules based on the average extend beyond the first decimal place. In the event of a tie, sites are presented in order of their Overall Care Rating from highest to lowest.

APPENDIX VII 134

Dimension of Care: Care and Services In 2019, the average Care and Services score for the 145 eligible sites was 83 out of 100, and individual site averages ranged from 64 to 98 out of 100. Table 10 below summarizes the 2019 site-level Care and Services averages and change in score from 2016 by AHS Zone (N = 145 sites). . When the Change from the 2016 survey is shaded GREEN this indicates that the 2019 score is statistically significantly HIGHER than the 2016 score.

. When the Change from the 2016 survey is shaded ORANGE this indicates that the 2019 score is statistically significantly LOWER than the 2016 score.

. No shade: 2019 and 2016 scores do not significantly differ. . “---" 2016 result unavailable.

Table 10: Care and Services

2019 Results Change North Zone (N = 17 sites) from N Average 2016 Heimstaed Lodge 5 98 --- Stone Brook 13 95 +10 Vilna Lodge 10 92 --- Whispering Pines Seniors Lodge 5 90 --- Manoir du Lac 12 89 --- Smithfield Lodge 12 89 +4 Mackenzie Place Supportive Living 31 89 --- NORTH ZONE AVERAGE --- 86 --- Points West Living Slave Lake 6 86 --- Shepherd's Care Barrhead 14 84 +13 Points West Living Peace River 10 84 +8 ALBERTA AVERAGE --- 83 --- J.B. Wood Continuing Care Centre 6 82 --- Grande Prairie Care Centre 15 82 --- Prairie Lake Seniors Community 21 82 --- Points West Living Cold Lake 6 82 --- Hinton Continuing Care Centre 11 81 --- Emerald Gardens Retirement Residence 10 79 -8 Edson Healthcare Centre 6 76 ---

APPENDIX VII 135

Table 10: Care and Services (continued)

2019 Results Change Edmonton Zone (N = 36 sites) from N Average 2016 Chartwell Wild Rose Retirement Residence 5 91 +15 Shepherd's Garden 16 91 +4 Good Samaritan Society Spruce Grove Centre 12 87 +2 CapitalCare Laurier House Strathcona 26 86 -1 Glastonbury Village (Mews) 21 86 +5 Shepherd's Care Vanguard 10 86 --- Emmanuel Home 6 85 +2 St. Albert Retirement Residence 11 85 --- Laurel Heights Retirement Residence 32 84 +4 Sprucewood Place 21 83 +11 Tuoi Hac - Golden Age Manor 28 83 +6 Copper Sky Lodge 53 83 +3 CapitalCare Dickinsfield 9 83 --- ALBERTA AVERAGE --- 83 --- Good Samaritan Society Wedman House 17 81 -0 Garneau Hall 8 81 -6 Saint Thomas Health Centre 35 80 -5 Chartwell Country Cottage Retirement Residence 11 80 -1 Lifestyle Options - Terra Losa 15 80 -6 Citadel Mews West 33 80 -5 Chartwell Aspen House 14 79 -5 EDMONTON ZONE AVERAGE --- 79 --- Riverbend Retirement Residence 11 79 -5 Chartwell Griesbach 25 78 -2 CapitalCare Laurier House Lynnwood 37 78 -3 Devonshire Manor 27 75 -5 Chateau Vitaline 11 75 -3 Grand Manor 22 75 --- Lifestyle Options Whitemud 12 75 -6 Villa Marguerite 50 74 +6 Rutherford Heights Retirement Residence 26 74 --- Good Samaritan Society George Hennig Place 19 73 -8 Chartwell St. Albert 22 73 -2 Summerwood Village Retirement Residence 7 72 +2 Our Parents' Home 5 71 --- Shepherds Care Kensington 21 71 -12 Salvation Army Grace Manor 29 69 +0 Rosedale Estates 20 64 -23

APPENDIX VII 136

Table 10: Care and Services (continued)

2019 Results Change Central Zone (N = 36 sites) from N Average 2016 Vermilion Valley Lodge 14 95 +12 Points West Living Lloydminster 11 93 --- Coronation Hospital and Care Centre 11 91 -2 Bashaw Meadows 15 90 +9 Pioneer House 11 89 --- Vegreville Manor 6 88 +8 Seasons Drayton Valley 8 87 +2 Wetaskiwin Meadows 14 86 -5 Seasons Retirement Camrose 15 86 +0 Hillview Lodge 18 85 --- Sundre Seniors Supportive Living 6 84 --- Eckville Manor House 11 83 --- West Park Lodge 13 83 -7 Park Avenue At Creekside 7 83 --- Seasons Retirement Ponoka 11 83 -1 ALBERTA AVERAGE --- 83 --- Providence Place 6 82 -12 Islay Assisted Living 11 81 -12 Seasons Retirement Olds 12 81 -1 CENTRAL ZONE AVERAGE --- 81 --- Royal Oak Manor 27 81 +4 Viewpoint 13 80 +2 Bethany Meadows 20 80 --- Century Park 6 78 --- Points West Living Wainwright 14 77 -12 Seasons Retirement Wetaskiwin 7 77 -15 Bethany Sylvan Lake 13 77 -11 Points West Living Stettler 27 76 +0 Timberstone Mews 20 76 --- Good Samaritan Good Shepherd Lutheran Home 28 75 -5 Extendicare Michener Hill 16 75 -7 Seasons Encore Olds 15 73 --- Heritage House 12 73 -1 Villa Marie 39 72 -6 Faith House 7 72 --- Points West Living Red Deer 21 72 --- Sunset Manor 21 71 -7 Clearwater Centre 18 68 -21

APPENDIX VII 137

Table 10: Care and Services (continued)

2019 Results Change Calgary Zone (N = 28 sites) from N Average 2016 Carewest Nickle House 6 97 +14 McKenzie Towne Retirement Residence 11 95 -2 Swan Evergreen Village 11 92 --- Providence Care Centre 15 90 --- Prince of Peace Manor 13 89 +7 Kingsland Terrace 16 89 +10 Aspen Ridge Lodge 10 88 -1 AgeCare Sagewood 27 87 +3 Edgemont Retirement Residence 12 86 +2 Whitehorn Village Retirement Community 20 86 -2 Wentworth Manor The Residence 18 86 +2 Revera Heartland 20 86 -1 Strafford Foundation Tudor Manor 49 85 -1 Silver Willow Lodge 16 85 -4 CALGARY ZONE AVERAGE --- 85 --- St. Marguerite Manor 26 84 -2 Bethany Didsbury 33 84 -1 AgeCare Walden Heights 87 84 +3 Holy Cross Manor 26 83 +2 ALBERTA AVERAGE --- 83 --- AgeCare Seton 75 82 -1 Eau Claire Retirement Residence 13 82 --- Seasons Retirement High River 36 82 +0 St. Teresa Place 55 82 --- Carewest Colonel Belcher Care Centre 16 81 +5 Scenic Acres Retirement Residence 8 81 +3 Sage Hill Retirement Residence 14 79 --- Evanston Grand Village 24 78 -8 Millrise Place 14 73 -8 Monterey Place 24 73 -13 2019 Results Change South Zone (N = 28 sites) from N Average 2016 York Creek Lodge 7 94 +2 AgeCare Orchard Manor 8 94 +11 Good Samaritan Society Prairie Ridge 21 93 +6 Chinook Lodge 13 91 +12 Clearview Lodge 14 90 -1 Masterpiece Southland Meadows 17 90 --- Haven Care Centre 12 89 +10

APPENDIX VII 138

Table 10: Care and Services (continued)

River Ridge Seniors Village 9 88 -3 Sunny South Lodge 24 88 +10 Golden Acres Lodge 21 87 -6 Good Samaritan Society Park Meadows Village 31 87 +3 Good Samaritan Society West Highlands 46 86 -1 Piyami Place 4 86 -6 Good Samaritan Society Lee Crest 27 86 +9 SOUTH ZONE AVERAGE --- 85 --- Good Samaritan Society Pincher Creek Vista Village 27 85 -0 Meadowlands Retirement Residence 6 85 +11 Legacy Lodge 53 84 -4 Extendicare Fairmont Park 36 84 +11 Meadow Ridge Seniors Village 13 83 +3 ALBERTA AVERAGE --- 83 --- Good Samaritan Garden Vista 8 82 -9 The Wellington Retirement Residence 26 82 -5 Cypress View Foundation Medicine Hat 25 82 -3 AgeCare Columbia 23 81 +4 St. Therese Villa 56 80 +3 Good Samaritan Society South Ridge Village 13 78 -4 St. Michael's Health Centre 12 76 --- AgeCare Sunrise Gardens 24 75 --- Good Samaritan Society Linden View 22 75 -9 Note: Categorical decision rules based on the average extend beyond the first decimal place. In the event of a tie, sites are presented in order of their Overall Care Rating from highest to lowest.

APPENDIX VII 139

Dimension of Care: Employee Responsiveness In 2019, the average Employee Responsiveness score for the 145 eligible sites was 86 out of 100, and individual site averages ranged from 66 to 97 out of 100. Table 11 below summarizes the 2019 site-level Employee Responsiveness averages and change in score from 2016 by AHS Zone (N = 145 sites). . When the Change from the 2016 survey is shaded GREEN this indicates that the 2019 score is statistically significantly HIGHER than the 2016 score.

. When the Change from the 2016 survey is shaded ORANGE this indicates that the 2019 score is statistically significantly LOWER than the 2016 score.

. No shade: 2019 and 2016 scores do not significantly differ. . “---" 2016 result unavailable.

Table 11: Employee Responsiveness

2019 Results Change North Zone (N = 17 sites) from N Average 2016 Heimstaed Lodge 6 97 --- Manoir du Lac 12 97 --- Vilna Lodge 10 94 --- Stone Brook 14 92 +5 Smithfield Lodge 12 90 -1 Shepherd's Care Barrhead 12 89 +8 Points West Living Slave Lake 6 88 --- ALBERTA AVERAGE --- 86 --- NORTH ZONE AVERAGE --- 86 --- Mackenzie Place Supportive Living 30 85 --- Points West Living Peace River 10 84 -6 Hinton Continuing Care Centre 11 83 --- Prairie Lake Seniors Community 21 83 --- Emerald Gardens Retirement Residence 10 83 -7 Points West Living Cold Lake 6 80 --- Grande Prairie Care Centre 15 79 --- Whispering Pines Seniors Lodge 5 79 --- J.B. Wood Continuing Care Centre 7 77 --- Edson Healthcare Centre 6 77 ---

APPENDIX VII 140

Table 11: Employee Responsiveness (continued)

2019 Results Change Edmonton Zone (N = 36 sites) from N Average 2016 Good Samaritan Society George Hennig Place 18 97 +8 Good Samaritan Society Spruce Grove Centre 13 95 -1 Garneau Hall 9 94 +2 Shepherd's Garden 15 92 +2 Chartwell Wild Rose Retirement Residence 4 91 -0 Devonshire Manor 24 90 +4 Chartwell Aspen House 14 90 -1 Good Samaritan Society Wedman House 14 90 +5 Citadel Mews West 29 89 -2 Glastonbury Village (Mews) 20 89 -6 Shepherds Care Kensington 21 89 +2 Our Parents' Home 5 88 --- Riverbend Retirement Residence 10 88 -2 EDMONTON ZONE AVERAGE --- 86 --- Copper Sky Lodge 53 86 +0 ALBERTA AVERAGE --- 86 --- Villa Marguerite 46 86 +9 Grand Manor 19 86 --- Chartwell Country Cottage Retirement Residence 11 86 -5 Lifestyle Options Whitemud 12 86 -0 Rutherford Heights Retirement Residence 23 86 --- CapitalCare Laurier House Strathcona 26 85 -7 Summerwood Village Retirement Residence 5 85 -4 Tuoi Hac - Golden Age Manor 28 85 -1 St. Albert Retirement Residence 10 85 --- CapitalCare Dickinsfield 9 84 --- Laurel Heights Retirement Residence 33 84 -0 Sprucewood Place 20 84 +1 Lifestyle Options - Terra Losa 13 83 -11 Emmanuel Home 6 83 -7 Saint Thomas Health Centre 34 83 -10 Rosedale Estates 21 83 -10 Chartwell St. Albert 21 82 -1 Shepherd's Care Vanguard 10 82 --- CapitalCare Laurier House Lynnwood 37 81 -6 Chartwell Griesbach 22 81 -8 Salvation Army Grace Manor 28 80 -4 Chateau Vitaline 12 77 -15

APPENDIX VII 141

Table 11: Employee Responsiveness (continued)

2019 Results Change Central Zone (N = 36 sites) from N Average 2016 Eckville Manor House 9 95 --- Vermilion Valley Lodge 13 95 +9 Providence Place 6 94 -2 Coronation Hospital and Care Centre 11 93 -1 Bethany Meadows 19 92 --- Points West Living Lloydminster 13 91 --- Bashaw Meadows 14 91 -1 Vegreville Manor 6 90 +5 Wetaskiwin Meadows 14 90 -6 Pioneer House 11 90 --- Seasons Retirement Ponoka 11 89 -0 Faith House 7 88 --- Islay Assisted Living 11 88 -7 Seasons Retirement Camrose 14 87 -0 West Park Lodge 13 87 -8 Points West Living Wainwright 14 87 -9 Seasons Retirement Wetaskiwin 7 87 -6 ALBERTA AVERAGE --- 86 --- Viewpoint 13 86 -6 Century Park 5 86 --- Points West Living Red Deer 19 84 --- CENTRAL ZONE AVERAGE --- 84 --- Sundre Seniors Supportive Living 4 84 --- Hillview Lodge 18 83 --- Sunset Manor 19 82 -0 Royal Oak Manor 27 81 -2 Good Samaritan Good Shepherd Lutheran Home 27 79 -0 Bethany Sylvan Lake 13 79 -15 Seasons Drayton Valley 10 79 -3 Heritage House 12 78 -9 Seasons Retirement Olds 11 78 -13 Extendicare Michener Hill 16 78 -6 Timberstone Mews 19 78 --- Clearwater Centre 18 75 -15 Points West Living Stettler 25 74 -11 Villa Marie 35 74 -7 Park Avenue At Creekside 7 73 --- Seasons Encore Olds 14 66 ---

APPENDIX VII 142

Table 11: Employee Responsiveness (continued)

2019 Results Change Calgary Zone (N = 28 sites) from N Average 2016 Providence Care Centre 15 94 --- Carewest Colonel Belcher Care Centre 16 92 +9 McKenzie Towne Retirement Residence 12 91 -8 Swan Evergreen Village 12 91 --- Holy Cross Manor 27 90 +7 Revera Heartland 21 90 -2 Scenic Acres Retirement Residence 9 90 +1 AgeCare Sagewood 28 89 -2 Edgemont Retirement Residence 12 89 -4 Sage Hill Retirement Residence 14 89 --- St. Marguerite Manor 26 89 -0 Prince of Peace Manor 14 89 +1 AgeCare Walden Heights 86 88 -0 Kingsland Terrace 16 88 +7 Carewest Nickle House 6 88 +7 Bethany Didsbury 32 87 +6 Whitehorn Village Retirement Community 18 87 -6 CALGARY ZONE AVERAGE --- 87 --- ALBERTA AVERAGE --- 86 --- AgeCare Seton 71 86 -4 Evanston Grand Village 24 86 -3 Silver Willow Lodge 16 85 -6 Seasons Retirement High River 35 84 +1 Strafford Foundation Tudor Manor 49 84 -3 Aspen Ridge Lodge 9 83 -15 Eau Claire Retirement Residence 13 82 --- St. Teresa Place 50 82 --- Wentworth Manor The Residence 17 80 -8 Millrise Place 13 77 -11 Monterey Place 23 76 -16 2019 Results Change South Zone (N = 28 sites) from N Average 2016 Chinook Lodge 13 97 +7 AgeCare Orchard Manor 7 97 +8 Clearview Lodge 14 94 -6 Good Samaritan Garden Vista 8 94 +2 Masterpiece Southland Meadows 18 92 --- Good Samaritan Society Pincher Creek Vista Village 27 92 +3 Cypress View Foundation Medicine Hat 23 92 -2

APPENDIX VII 143

Table 11: Employee Responsiveness (continued)

Golden Acres Lodge 21 92 -5 York Creek Lodge 7 92 -5 Good Samaritan Society West Highlands 45 90 -1 Haven Care Centre 12 90 +6 Sunny South Lodge 22 90 +2 Good Samaritan Society Lee Crest 27 89 +7 Meadowlands Retirement Residence 6 88 +7 SOUTH ZONE AVERAGE --- 88 --- St. Michael's Health Centre 12 87 --- Good Samaritan Society Prairie Ridge 22 87 +2 AgeCare Columbia 24 87 +0 River Ridge Seniors Village 8 87 -2 Extendicare Fairmont Park 37 86 +7 ALBERTA AVERAGE --- 86 --- The Wellington Retirement Residence 26 85 -2 Good Samaritan Society Park Meadows Village 31 85 -2 Legacy Lodge 53 85 -3 Good Samaritan Society South Ridge Village 12 83 -3 St. Therese Villa 57 82 -1 Good Samaritan Society Linden View 22 80 -8 Meadow Ridge Seniors Village 13 79 +5 Piyami Place 4 77 -18 AgeCare Sunrise Gardens 25 77 --- Note: Categorical decision rules based on the average extend beyond the first decimal place. In the event of a tie, sites are presented in order of their Overall Care Rating from highest to lowest.

APPENDIX VII 144

Dimension of Care: Laundry In 2019, the average Laundry score for the 145 eligible sites was 92 out of 100, and individual site averages ranged from 63 to 100 out of 100. Table 12 below summarizes the 2019 site-level Laundry averages and change in score from 2016 by AHS Zone (N = 145 sites). . When the Change from the 2016 survey is shaded GREEN this indicates that the 2019 score is statistically significantly HIGHER than the 2016 score.

. When the Change from the 2016 survey is shaded ORANGE this indicates that the 2019 score is statistically significantly LOWER than the 2016 score.

. No shade: 2019 and 2016 scores do not significantly differ. . “---" 2016 result unavailable.

Table 12: Laundry

2019 Results Change North Zone (N = 17 sites) from N Average 2016 Heimstaed Lodge 4 100 --- Whispering Pines Seniors Lodge 3 100 --- Manoir du Lac 6 100 --- Vilna Lodge 9 98 --- Points West Living Slave Lake 6 97 --- Emerald Gardens Retirement Residence 5 97 -3 Grande Prairie Care Centre 12 96 --- Stone Brook 14 95 +6 Prairie Lake Seniors Community 14 95 --- Shepherd's Care Barrhead 10 93 +4 NORTH ZONE AVERAGE --- 93 --- Mackenzie Place Supportive Living 17 92 --- Points West Living Peace River 6 92 -1 ALBERTA AVERAGE --- 92 --- Smithfield Lodge 12 91 -4 Points West Living Cold Lake 6 86 --- J.B. Wood Continuing Care Centre 4 85 --- Hinton Continuing Care Centre 2 83 --- Edson Healthcare Centre 2 75 ---

APPENDIX VII 145

Table 12: Laundry (continued)

2019 Results Change Edmonton Zone (N = 36 sites) from N Average 2016 Chartwell Wild Rose Retirement Residence 3 100 +8 CapitalCare Dickinsfield 9 98 --- Chartwell Aspen House 10 97 +3 Shepherd's Garden 13 96 -2 Shepherd's Care Vanguard 8 96 --- Citadel Mews West 15 95 -1 Rosedale Estates 15 95 +5 Good Samaritan Society Spruce Grove Centre 7 95 -5 St. Albert Retirement Residence 7 95 --- Lifestyle Options Whitemud 10 95 +6 Chartwell Country Cottage Retirement Residence 6 94 -6 Chartwell St. Albert 15 94 +4 Shepherds Care Kensington 19 94 +2 Riverbend Retirement Residence 8 94 +3 Sprucewood Place 16 94 +6 Glastonbury Village (Mews) 15 93 -7 Tuoi Hac - Golden Age Manor 26 93 -1 Lifestyle Options - Terra Losa 14 93 -4 Copper Sky Lodge 44 92 +4 Good Samaritan Society Wedman House 9 92 -3 CapitalCare Laurier House Lynnwood 24 92 +1 EDMONTON ZONE AVERAGE --- 92 --- CapitalCare Laurier House Strathcona 20 92 -5 ALBERTA AVERAGE --- 92 --- Devonshire Manor 9 91 -1 Grand Manor 20 91 --- Emmanuel Home 4 90 -10 Garneau Hall 4 90 -10 Chateau Vitaline 8 90 -3 Saint Thomas Health Centre 28 89 -3 Laurel Heights Retirement Residence 22 89 -2 Our Parents' Home 3 89 --- Good Samaritan Society George Hennig Place 18 89 +5 Rutherford Heights Retirement Residence 7 88 --- Salvation Army Grace Manor 19 86 -10 Summerwood Village Retirement Residence 4 83 -6 Villa Marguerite 35 83 -6 Chartwell Griesbach 14 82 -11

APPENDIX VII 146

Table 12: Laundry (continued)

2019 Results Change Central Zone (N = 36 sites) from N Average 2016 Eckville Manor House 10 100 --- Vermilion Valley Lodge 14 100 +7 Sundre Seniors Supportive Living 1 100 --- Wetaskiwin Meadows 2 100 0 Coronation Hospital and Care Centre 4 100 0 Seasons Retirement Wetaskiwin 2 100 +3 Viewpoint 8 100 +4 Royal Oak Manor 10 98 -2 Seasons Retirement Ponoka 7 98 +6 Vegreville Manor 6 97 +1 Bethany Sylvan Lake 6 97 +3 Heritage House 9 96 +7 Providence Place 4 96 -4 Seasons Retirement Olds 4 96 +21 Pioneer House 11 95 --- Points West Living Lloydminster 10 95 --- Bethany Meadows 16 94 --- Hillview Lodge 18 94 --- Faith House 5 93 --- Islay Assisted Living 10 93 -4 Bashaw Meadows 12 93 -1 Timberstone Mews 8 92 --- ALBERTA AVERAGE --- 92 --- CENTRAL ZONE AVERAGE --- 91 --- West Park Lodge 12 91 -3 Points West Living Red Deer 13 91 --- Seasons Drayton Valley 4 90 +13 Century Park 5 90 --- Points West Living Stettler 21 89 +2 Points West Living Wainwright 14 85 -13 Villa Marie 30 84 +0 Clearwater Centre 14 82 -2 Extendicare Michener Hill 9 82 -11 Seasons Retirement Camrose 11 80 -13 Good Samaritan Good Shepherd Lutheran Home 16 78 -1 Sunset Manor 14 76 -16 Park Avenue At Creekside 2 75 --- Seasons Encore Olds 7 69 ---

APPENDIX VII 147

Table 12: Laundry (continued)

2019 Results Change Calgary Zone (N = 28 sites) from N Average 2016 Aspen Ridge Lodge 3 100 +8 Prince of Peace Manor 3 100 0 Scenic Acres Retirement Residence 1 100 0 Revera Heartland 2 100 +10 AgeCare Sagewood 13 99 +3 Wentworth Manor The Residence 8 98 +3 Providence Care Centre 9 98 --- Bethany Didsbury 23 97 +11 AgeCare Walden Heights 43 96 +3 Silver Willow Lodge 11 95 +0 Edgemont Retirement Residence 7 95 -5 Whitehorn Village Retirement Community 13 95 -4 McKenzie Towne Retirement Residence 3 94 -6 Kingsland Terrace 5 93 +9 Carewest Nickle House 5 93 +3 CALGARY ZONE AVERAGE --- 93 --- AgeCare Seton 38 92 -3 Monterey Place 13 92 +2 Carewest Colonel Belcher Care Centre 6 92 +8 ALBERTA AVERAGE --- 92 --- Seasons Retirement High River 20 91 +8 Evanston Grand Village 19 90 -7 Eau Claire Retirement Residence 5 90 --- Holy Cross Manor 20 90 +3 Strafford Foundation Tudor Manor 32 90 +2 St. Teresa Place 39 88 --- Swan Evergreen Village 9 88 --- St. Marguerite Manor 15 87 -6 Millrise Place 9 85 -8 Sage Hill Retirement Residence 5 83 --- 2019 Results Change South Zone (N = 28 sites) from N Average 2016 Meadowlands Retirement Residence 4 100 --- St. Michael's Health Centre 10 98 --- Golden Acres Lodge 12 97 -0 Good Samaritan Society Prairie Ridge 19 95 +1 River Ridge Seniors Village 6 94 +4 Good Samaritan Society Pincher Creek Vista Village 27 94 +3 Good Samaritan Society South Ridge Village 11 92 +1

APPENDIX VII 148

Table 12: Laundry (continued)

York Creek Lodge 6 92 0 Meadow Ridge Seniors Village 10 92 -1 ALBERTA AVERAGE --- 92 --- Good Samaritan Society West Highlands 40 92 -3 AgeCare Columbia 14 91 -4 Chinook Lodge 10 91 -0 Good Samaritan Society Linden View 20 91 -2 The Wellington Retirement Residence 20 90 +2 Extendicare Fairmont Park 26 90 -3 SOUTH ZONE AVERAGE --- 89 --- Clearview Lodge 9 89 -8 Sunny South Lodge 17 89 -0 Good Samaritan Society Park Meadows Village 26 89 +1 Masterpiece Southland Meadows 12 88 --- AgeCare Sunrise Gardens 19 88 --- AgeCare Orchard Manor 6 88 -8 Good Samaritan Garden Vista 8 88 -2 Good Samaritan Society Lee Crest 20 88 -0 Legacy Lodge 39 87 -2 St. Therese Villa 48 86 -3 Piyami Place 5 83 -8 Cypress View Foundation Medicine Hat 14 76 -21 Haven Care Centre 6 63 -12 Note: Categorical decision rules based on the average extend beyond the first decimal place. In the event of a tie, sites are presented in order of their Overall Care Rating from highest to lowest.

APPENDIX VII 149

Dimension of Care: General Satisfaction In 2019, the average General Satisfaction score for the 145 eligible sites was 85 out of 100, and individual site averages ranged from 64 to 100 out of 100. Table 13 below summarizes the 2019 site-level General Satisfaction averages and change in score from 2016 by AHS Zone (N = 145 sites). . When the Change from the 2016 survey is shaded GREEN this indicates that the 2019 score is statistically significantly HIGHER than the 2016 score.

. When the Change from the 2016 survey is shaded ORANGE this indicates that the 2019 score is statistically significantly LOWER than the 2016 score.

. No shade: 2019 and 2016 scores do not significantly differ. . “---" 2016 result unavailable.

Table 13: General Satisfaction

2019 Results Change North Zone (N = 17 sites) from N Average 2016 Vilna Lodge 10 100 --- Heimstaed Lodge 6 96 --- Stone Brook 14 91 +14 Points West Living Slave Lake 6 90 --- Manoir du Lac 12 89 --- Smithfield Lodge 11 88 +2 Shepherd's Care Barrhead 14 86 +9 ALBERTA AVERAGE --- 85 --- NORTH ZONE AVERAGE --- 82 --- Grande Prairie Care Centre 15 81 --- Emerald Gardens Retirement Residence 10 81 +2 Hinton Continuing Care Centre 11 81 --- Points West Living Peace River 10 80 -5 Prairie Lake Seniors Community 21 79 --- Mackenzie Place Supportive Living 31 79 --- Whispering Pines Seniors Lodge 5 75 --- Points West Living Cold Lake 6 71 --- Edson Healthcare Centre 5 65 --- J.B. Wood Continuing Care Centre 6 64 ---

APPENDIX VII 150

Table 13: General Satisfaction (continued)

2019 Results Change Edmonton Zone (N = 36 sites) from N Average 2016 Chartwell Wild Rose Retirement Residence 5 100 +13 Lifestyle Options Whitemud 12 94 +14 Glastonbury Village (Mews) 21 93 +6 CapitalCare Dickinsfield 8 92 --- Shepherd's Garden 17 91 +6 Tuoi Hac - Golden Age Manor 28 90 +6 Our Parents' Home 5 90 --- Good Samaritan Society Spruce Grove Centre 13 89 -8 Good Samaritan Society George Hennig Place 20 89 +5 Chartwell Country Cottage Retirement Residence 11 89 +8 Devonshire Manor 27 89 -2 Emmanuel Home 6 88 +0 St. Albert Retirement Residence 11 88 --- Citadel Mews West 33 88 -2 Riverbend Retirement Residence 11 88 -0 CapitalCare Laurier House Strathcona 27 87 -7 CapitalCare Laurier House Lynnwood 38 87 -2 Shepherds Care Kensington 22 87 +4 Copper Sky Lodge 54 87 +5 Chartwell St. Albert 22 86 +3 Rosedale Estates 21 86 -2 EDMONTON ZONE AVERAGE --- 86 --- Lifestyle Options - Terra Losa 15 85 -6 ALBERTA AVERAGE --- 85 --- Chateau Vitaline 12 85 -6 Rutherford Heights Retirement Residence 24 85 --- Laurel Heights Retirement Residence 33 84 +5 Shepherd's Care Vanguard 9 83 --- Sprucewood Place 21 83 +15 Chartwell Aspen House 14 83 -10 Grand Manor 22 80 --- Good Samaritan Society Wedman House 17 80 -5 Garneau Hall 8 80 -5 Chartwell Griesbach 26 80 -6 Saint Thomas Health Centre 36 80 +0 Villa Marguerite 52 74 +14 Summerwood Village Retirement Residence 7 72 -15 Salvation Army Grace Manor 30 72 -3

APPENDIX VII 151

Table 13: General Satisfaction (continued)

2019 Results Change Central Zone (N = 36 sites) from N Average 2016 Century Park 6 95 --- Vermilion Valley Lodge 14 94 +19 Eckville Manor House 11 94 --- Bashaw Meadows 15 94 +12 Providence Place 5 91 -6 Points West Living Red Deer 21 90 --- Points West Living Lloydminster 12 90 --- West Park Lodge 13 90 -4 Pioneer House 11 90 --- Hillview Lodge 17 89 --- Vegreville Manor 5 87 +3 Seasons Retirement Wetaskiwin 7 86 +8 Wetaskiwin Meadows 14 86 -2 Islay Assisted Living 12 86 -6 ALBERTA AVERAGE --- 85 --- Royal Oak Manor 27 84 +2 Timberstone Mews 20 84 --- Sundre Seniors Supportive Living 6 83 --- CENTRAL ZONE AVERAGE --- 83 --- Points West Living Wainwright 14 83 -14 Park Avenue At Creekside 8 81 --- Points West Living Stettler 29 81 -1 Clearwater Centre 18 81 -0 Extendicare Michener Hill 16 81 -5 Good Samaritan Good Shepherd Lutheran Home 26 81 -3 Bethany Sylvan Lake 13 81 -9 Coronation Hospital and Care Centre 11 80 -2 Bethany Meadows 20 80 --- Seasons Drayton Valley 9 79 +2 Seasons Retirement Olds 13 78 -8 Seasons Encore Olds 15 78 --- Seasons Retirement Camrose 15 78 -11 Faith House 7 77 --- Sunset Manor 21 76 -10 Villa Marie 38 76 -6 Seasons Retirement Ponoka 12 74 -11 Viewpoint 13 73 -6 Heritage House 12 72 -0

APPENDIX VII 152

Table 13: General Satisfaction (continued)

2019 Results Change Calgary Zone (N = 28 sites) from N Average 2016 Prince of Peace Manor 14 96 +6 Carewest Colonel Belcher Care Centre 16 93 -0 Scenic Acres Retirement Residence 9 90 -2 St. Marguerite Manor 27 90 +1 Evanston Grand Village 23 90 +2 McKenzie Towne Retirement Residence 12 90 -9 Whitehorn Village Retirement Community 20 90 -1 AgeCare Sagewood 28 89 +3 Revera Heartland 22 88 +0 Swan Evergreen Village 12 87 --- Strafford Foundation Tudor Manor 50 86 -4 AgeCare Walden Heights 90 86 -3 Seasons Retirement High River 35 86 +5 Wentworth Manor The Residence 17 86 -3 CALGARY ZONE AVERAGE --- 85 --- Holy Cross Manor 27 85 -0 AgeCare Seton 78 85 -5 ALBERTA AVERAGE --- 85 --- Aspen Ridge Lodge 9 85 -10 Providence Care Centre 15 84 --- Bethany Didsbury 34 84 +0 Sage Hill Retirement Residence 15 84 --- Carewest Nickle House 6 83 -7 Eau Claire Retirement Residence 13 83 --- Edgemont Retirement Residence 13 82 -9 Kingsland Terrace 16 82 +25 St. Teresa Place 55 82 --- Monterey Place 26 80 -2 Silver Willow Lodge 16 73 -20 Millrise Place 14 68 -11 2019 Results Change South Zone (N = 28 sites) from N Average 2016 Chinook Lodge 13 97 +6 Sunny South Lodge 22 95 +11 AgeCare Orchard Manor 8 93 +7 Clearview Lodge 14 92 -5 Golden Acres Lodge 21 92 +2 Masterpiece Southland Meadows 17 92 --- Good Samaritan Society West Highlands 46 91 -1

APPENDIX VII 153

Table 13: General Satisfaction (continued)

Good Samaritan Society Prairie Ridge 22 91 +3 Haven Care Centre 12 91 +3 Good Samaritan Society Pincher Creek Vista Village 27 91 +4 Cypress View Foundation Medicine Hat 25 90 -5 AgeCare Sunrise Gardens 24 90 --- York Creek Lodge 7 89 +10 Good Samaritan Garden Vista 7 89 -8 SOUTH ZONE AVERAGE --- 87 --- River Ridge Seniors Village 9 87 -4 St. Therese Villa 55 87 +3 The Wellington Retirement Residence 26 86 -1 Meadowlands Retirement Residence 6 86 +0 Extendicare Fairmont Park 37 86 -3 ALBERTA AVERAGE --- 85 --- Legacy Lodge 53 84 -6 Good Samaritan Society Lee Crest 28 83 +5 Good Samaritan Society South Ridge Village 13 83 -1 AgeCare Columbia 24 82 +4 Good Samaritan Society Park Meadows Village 31 82 -3 Meadow Ridge Seniors Village 13 82 +1 St. Michael's Health Centre 12 82 --- Good Samaritan Society Linden View 22 77 -7 Piyami Place 5 74 -13 Note: Categorical decision rules based on the average extend beyond the first decimal place. In the event of a tie, sites are presented in order of their Overall Care Rating from highest to lowest.

APPENDIX VII 154

APPENDIX VIII: SUMMARY OF 2019 PROVINCIAL AND ZONE-LEVEL RESPONSES TO INDIVIDUAL SURVEY QUESTIONS

This section presents respondent-level results to the survey questions that make up the Dimensions of Care and the Additional Care questions.

Notes: Percentages may not always add to 100 per cent due to rounding. Responses Don’t Know and Not applicable were coded as missing.

Table 1: Dimension of Care: Activities question-level results by AHS Zone

Q1: Do you have enough to do here? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,672) (N = 210) (N = 717) (N = 493) (N = 656) (N = 596) % % % % % % Yes, always 49 49 56 44 49 47 Yes, sometimes 33 31 26 34 36 39 No, hardly ever 13 12 12 16 12 11 No never 5 8 6 6 3 3 Total 100 100 100 100 100 100 Q2: Do you get enough information about the activities offered here? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,695) (N = 209) (N = 704) (N = 502) (N = 679) (N = 601) % % % % % % Yes, always 63 62 69 61 62 60 Yes, sometimes 27 28 20 28 28 31 No, hardly ever 7 8 6 6 9 8 No never 3 3 4 4 1 1 Total 100 100 100 100 100 100 Q3: Are you satisfied with the activities offered here? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,552) (N = 199) (N = 675) (N = 478) (N = 621) (N = 579) % % % % % % Yes, always 50 52 53 45 48 53 Yes, sometimes 36 34 34 40 37 34 No, hardly ever 10 10 8 10 13 11 No never 4 4 6 5 2 2 Total 100 100 100 100 100 100

APPENDIX VIII 155

Table 1: Dimension of Care: Activities question-level results by AHS Zone (continued)

Q4: Can you choose what activities you do here? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,562) (N = 194) (N = 693) (N = 461) (N = 638) (N = 576) % % % % % % Yes, always 68 71 76 52 69 67 Yes, sometimes 22 19 16 35 21 22 No, hardly ever 7 5 4 8 8 8 No never 3 5 3 4 3 4 Total 100 100 100 100 100 100

APPENDIX VIII 156

Table 2: Dimension of Care: Choice question-level results by AHS Zone

Q5: Can you go to bed when you like? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,791) (N = 215) (N = 738) (N = 528) (N = 706) (N = 604) % % % % % % Yes, always 80 78 79 78 83 78 Yes, sometimes 14 17 12 17 13 15 No, hardly ever 4 4 5 4 3 4 No never 2 1 4 1 1 3 Total 100 100 100 100 100 100 Q6: Do the employees leave you alone if you don’t want to do anything? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,724) (N = 218) (N = 714) (N = 502) (N = 693) (N = 597) % % % % % % Yes, always 75 78 78 68 78 74 Yes, sometimes 22 20 17 30 19 23 No, hardly ever 2 2 3 2 2 2 No never 1 0 2 1 1 1 Total 100 100 100 100 100 100 Q7: Do the people who work here encourage you to do things you are able to do yourself? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,637) (N = 208) (N = 693) (N = 507) (N = 644) (N = 585) % % % % % % Yes, always 64 74 68 57 65 59 Yes, sometimes 27 21 21 36 25 32 No, hardly ever 6 4 6 6 7 6 No never 3 1 5 2 3 3 Total 100 100 100 100 100 100 Q8: Are you free to come and go as you are able? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,741) (N = 217) (N = 710) (N = 516) (N = 699) (N = 599) % % % % % % Yes, always 82 84 83 76 83 87 Yes, sometimes 13 12 10 21 13 10 No, hardly ever 3 3 3 3 3 3 No never 2 1 4 1 2 1 Total 100 100 100 100 100 100

APPENDIX VIII 157

Table 2: Dimension of Care: Choice question-level results by AHS Zone (continued)

Q9: Are the rules here reasonable? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,696) (N = 211) (N = 710) (N = 511) (N = 674) (N = 590) % % % % % % Yes, always 74 79 75 67 74 76 Yes, sometimes 22 18 19 28 22 20 No, hardly ever 3 2 3 4 2 3 No never 1 1 2 2 1 < 1 Total 100 100 100 100 100 100 Q10: Can you choose what clothes to wear? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,796) (N = 215) (N = 737) (N = 529) (N = 709) (N = 606) % % % % % % Yes, always 90 87 93 86 93 90 Yes, sometimes 8 11 5 12 6 8 No, hardly ever 1 1 1 2 1 1 No never 1 < 1 1 < 1 < 1 < 1 Total 100 100 100 100 100 100

APPENDIX VIII 158

Table 3: Dimension of Care: Care and Services question-level results by AHS Zone

Q11: Can you get snacks and drinks whenever you want them? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,483) (N = 189) (N = 654) (N = 476) (N = 622) (N = 542) % % % % % % Yes, always 58 72 49 55 58 65 Yes, sometimes 27 17 24 36 29 24 No, hardly ever 9 7 13 7 10 6 No never 6 3 14 3 3 5 Total 100 100 100 100 100 100 Q12: Do you get your medications on time? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,655) (N = 214) (N = 706) (N = 491) (N = 660) (N = 584) % % % % % % Yes, always 76 81 80 63 79 76 Yes, sometimes 21 17 18 34 20 19 No, hardly ever 2 1 2 2 1 4 No never 0 < 1 1 1 < 1 < 1 Total 100 100 100 100 100 100 Q13: Do employees explain your care and services to you? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,529) (N = 205) (N = 669) (N = 482) (N = 611) (N = 562) % % % % % % Yes, always 55 68 53 41 58 62 Yes, sometimes 30 24 27 44 28 25 No, hardly ever 11 6 12 11 11 10 No never 5 2 8 4 3 4 Total 100 100 100 100 100 100 Q14: Do the employees who take care of you know what you like and you don’t like? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,587) (N = 209) (N = 682) (N = 495) (N = 644) (N = 557) % % % % % % Yes, always 51 61 54 39 51 54 Yes, sometimes 41 33 37 53 41 39 No, hardly ever 5 5 6 5 5 5 No never 3 1 4 3 2 2 Total 100 100 100 100 100 100

APPENDIX VIII 159

Table 4: Dimension of Care: Relationship with Employees question-level results by AHS Zone

Q15: Are the employees courteous to you? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,805) (N = 215) (N = 741) (N = 531) (N = 709) (N = 609) % % % % % % Yes, always 76 80 73 75 79 78 Yes, sometimes 22 17 25 23 21 20 No, hardly ever 1 2 2 2 1 1 No never < 1 0 1 < 1 0 1 Total 100 100 100 100 100 100 Q16: Can you depend on the employees? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,739) (N = 218) (N = 707) (N = 525) (N = 688) (N = 601) % % % % % % Yes, always 62 68 61 56 64 63 Yes, sometimes 33 27 33 40 32 32 No, hardly ever 4 6 4 4 3 5 No never 1 0 2 < 1 < 1 < 1 Total 100 100 100 100 100 100 Q17: Are the people who work here friendly? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,815) (N = 221) (N = 744) (N = 529) (N = 707) (N = 614) % % % % % % Yes, always 76 78 75 72 79 78 Yes, sometimes 22 21 23 26 21 21 No, hardly ever 1 1 2 2 < 1 1 No never < 1 0 < 1 < 1 0 < 1 Total 100 100 100 100 100 100 Q18: Do the employees treat you with respect? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,800) (N = 218) (N = 734) (N = 531) (N = 704) (N = 613) % % % % % % Yes, always 78 83 76 73 80 82 Yes, sometimes 20 17 22 25 19 17 No, hardly ever 1 1 1 2 1 1 No never < 1 0 1 0 < 1 < 1 Total 100 100 100 100 100 100

APPENDIX VIII 160

Table 5: Dimension of Care: Employee Responsiveness question-level results by AHS Zone

Q19: During the week, are the employees available to help you if you need it? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,648) (N = 216) (N = 683) (N = 499) (N = 666) (N = 584) % % % % % % Yes, always 66 70 71 51 70 66 Yes, sometimes 31 29 25 46 27 31 No, hardly ever 3 1 3 3 2 3 No never < 1 0 1 < 1 < 1 < 1 Total 100 100 100 100 100 100 Q20: During the weekend, are the employees available to help you if you need it? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,584) (N = 209) (N = 659) (N = 493) (N = 647) (N = 576) % % % % % % Yes, always 54 55 58 41 55 57 Yes, sometimes 39 40 34 52 38 37 No, hardly ever 6 3 6 7 7 6 No never 1 2 2 1 1 < 1 Total 100 100 100 100 100 100 Q21: During the evening and night, are the employees available to help you if you need it? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,536) (N = 204) (N = 640) (N = 479) (N = 630) (N = 583) % % % % % % Yes, always 65 69 69 47 68 73 Yes, sometimes 30 27 25 46 29 24 No, hardly ever 4 3 5 7 3 3 No never 1 < 1 2 < 1 1 0 Total 100 100 100 100 100 100 Q22: Do you feel confident that employees know how to do their jobs? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,747) (N = 215) (N = 724) (N = 522) (N = 696) (N = 590) % % % % % % Yes, always 61 69 60 53 62 67 Yes, sometimes 33 26 33 41 33 27 No, hardly ever 5 5 5 5 4 5 No never 1 < 1 2 1 1 1 Total 100 100 100 100 100 100

APPENDIX VIII 161

Table 6: Dimension of Care: Communication question-level results by AHS Zone

Q23: Are the people in charge available to talk with you? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,485) (N = 204) (N = 649) (N = 469) (N = 603) (N = 560) % % % % % % Yes, always 60 69 63 55 58 61 Yes, sometimes 31 25 28 36 34 31 No, hardly ever 6 5 7 6 6 7 No never 2 1 3 3 1 1 Total 100 100 100 100 100 100 Q24: Do the people in charge treat you with respect? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,635) (N = 210) (N = 688) (N = 482) (N = 667) (N = 588) % % % % % % Yes, always 82 86 83 76 83 83 Yes, sometimes 16 12 14 22 15 14 No, hardly ever 2 2 1 2 1 2 No never 1 0 1 < 1 1 1 Total 100 100 100 100 100 100 Q25: Would you feel comfortable speaking to the people in charge about a problem? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,656) (N = 203) (N = 696) (N = 499) (N = 680) (N = 578) % % % % % % Yes, always 73 74 75 71 74 70 Yes, sometimes 19 16 15 22 21 20 No, hardly ever 5 5 5 4 4 7 No never 3 4 5 3 2 2 Total 100 100 100 100 100 100 Q26: Do you know who to go to here when you have a problem? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,576) (N = 202) (N = 693) (N = 479) (N = 653) (N = 549) % % % % % % Yes, always 68 75 73 62 64 69 Yes, sometimes 21 18 16 27 24 19 No, hardly ever 7 5 5 7 9 8 No never 4 2 5 5 3 4 Total 100 100 100 100 100 100

APPENDIX VIII 162

Table 6: Dimension of Care: Communication question-level results by AHS Zone (continued)

Q27: Do your problems get taken care of here? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,439) (N = 190) (N = 652) (N = 444) (N = 610) (N = 543) % % % % % % Yes, always 57 70 57 48 57 61 Yes, sometimes 33 24 31 41 34 29 No, hardly ever 7 5 7 9 6 7 No never 3 1 4 2 3 2 Total 100 100 100 100 100 100

APPENDIX VIII 163

Table 7: Dimension of Care: Meals and Dining question-level results by AHS Zone

Q28: Do you get enough to eat? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,805) (N = 221) (N = 738) (N = 524) (N = 708) (N = 614) % % % % % % Yes, always 83 86 84 82 79 85 Yes, sometimes 14 11 13 14 17 14 No, hardly ever 3 2 2 2 4 1 No never 1 1 1 1 1 < 1 Total 100 100 100 100 100 100 Q29: Is the food here tasty? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,797) (N = 221) (N = 735) (N = 528) (N = 704) (N = 609) % % % % % % Yes, always 37 47 40 30 34 41 Yes, sometimes 44 37 42 50 46 44 No, hardly ever 13 10 12 15 15 11 No never 5 6 5 5 5 4 Total 100 100 100 100 100 100 Q30: Can you get the foods you like? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,621) (N = 208) (N = 692) (N = 501) (N = 656) (N = 564) % % % % % % Yes, always 33 40 35 24 31 37 Yes, sometimes 43 38 42 49 43 42 No, hardly ever 17 14 15 20 20 15 No never 7 8 7 7 5 7 Total 100 100 100 100 100 100 Q31: Is your food served at the right temperature? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,774) (N = 216) (N = 732) (N = 525) (N = 697) (N = 604) % % % % % % Yes, always 46 54 49 40 43 47 Yes, sometimes 39 34 36 43 38 42 No, hardly ever 12 8 11 13 15 9 No never 4 4 5 3 4 2 Total 100 100 100 100 100 100

APPENDIX VIII 164

Table 7: Dimension of Care: Meals and Dining question-level results by AHS Zone (continued)

Q32: Do you like the way your meals are served here? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,752) (N = 215) (N = 727) (N = 520) (N = 692) (N = 598) % % % % % % Yes, always 61 70 62 53 58 66 Yes, sometimes 30 21 30 38 30 27 No, hardly ever 7 7 6 7 9 6 No never 3 1 3 3 3 2 Total 100 100 100 100 100 100 Q33: Does the food here meet your dietary needs? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,408) (N = 195) (N = 648) (N = 439) (N = 636) (N = 490) % % % % % % Yes, always 62 68 66 53 61 63 Yes, sometimes 26 23 23 34 24 26 No, hardly ever 9 7 8 9 11 7 No never 4 3 4 4 3 3 Total 100 100 100 100 100 100

APPENDIX VIII 165

Table 8: Dimension of Care: Laundry question-level results by AHS Zone

Q34: Do you get your clothing back from the laundry? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 1,827) (N = 153) (N = 512) (N = 343) (N = 373) (N = 446) % % % % % % Yes, always 76 82 79 74 79 72 Yes, sometimes 21 17 18 24 20 25 No, hardly ever 2 0 3 3 1 1 No never 1 1 < 1 0 < 1 2 Total 100 100 100 100 100 100 Q35: Does your clothing come back from the laundry in good condition? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 1,827) (N = 147) (N = 502) (N = 343) (N = 371) (N = 464) % % % % % % Yes, always 77 85 80 74 79 73 Yes, sometimes 19 14 16 21 19 23 No, hardly ever 3 1 3 3 2 3 No never 1 0 1 1 < 1 1 Total 100 100 100 100 100 100

APPENDIX VIII 166

Table 9: Dimension of Care: Facility Environment question-level results by AHS Zone

Q36: Do you like the location of this place? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,626) (N = 204) (N = 705) (N = 496) (N = 643) (N = 578) % % % % % % Yes, always 72 74 73 63 72 78 Yes, sometimes 21 21 21 30 20 17 No, hardly ever 4 2 4 5 4 3 No never 3 3 2 2 4 2 Total 100 100 100 100 100 100 Q37: Are the outside walkways and grounds well taken care of? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,531) (N = 194) (N = 671) (N = 469) (N = 633) (N = 564) % % % % % % Yes, always 81 79 80 71 85 86 Yes, sometimes 17 18 18 27 14 13 No, hardly ever 2 4 2 2 1 1 No never < 1 0 < 1 1 < 1 < 1 Total 100 100 100 100 100 100 Q38: Does this place look attractive to you? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,669) (N = 207) (N = 720) (N = 491) (N = 660) (N = 591) % % % % % % Yes, always 75 74 76 63 79 81 Yes, sometimes 20 22 18 30 18 15 No, hardly ever 4 2 4 5 2 3 No never 1 1 2 2 1 1 Total 100 100 100 100 100 100 Q39: Is this place clean enough? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,811) (N = 220) (N = 748) (N = 526) (N = 703) (N = 614) % % % % % % Yes, always 81 80 80 78 85 81 Yes, sometimes 16 18 16 18 14 15 No, hardly ever 2 < 1 3 2 1 3 No never 1 1 1 1 < 1 1 Total 100 100 100 100 100 100

APPENDIX VIII 167

Table 9: Dimension of Care: Facility Environment question-level results by AHS Zone (continued)

Q40: Is this place quiet when it should be? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,798) (N = 222) (N = 734) (N = 529) (N = 702) (N = 611) % % % % % % Yes, always 76 77 78 75 78 72 Yes, sometimes 21 20 17 22 19 25 No, hardly ever 3 1 3 3 3 3 No never 1 1 2 < 1 < 1 < 1 Total 100 100 100 100 100 100

APPENDIX VIII 168

Table 10: Dimension of Care: Resident Environment question-level results by AHS Zone

Q41: Do you have enough privacy in your room or apartment? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,816) (N = 221) (N = 747) (N = 526) (N = 708) (N = 614) % % % % % % Yes, always 82 86 83 82 83 81 Yes, sometimes 14 11 13 14 14 16 No, hardly ever 3 1 3 3 3 3 No never 1 1 1 1 < 1 < 1 Total 100 100 100 100 100 100 Q42: Are you satisfied with your room or apartment? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,818) (N = 221) (N = 747) (N = 530) (N = 706) (N = 614) % % % % % % Yes, always 79 81 80 72 79 82 Yes, sometimes 17 15 15 24 17 15 No, hardly ever 3 1 3 4 2 2 No never 1 2 2 1 2 1 Total 100 100 100 100 100 100 Q43: Do you feel safe here? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,811) (N = 220) (N = 743) (N = 528) (N = 711) (N = 609) % % % % % % Yes, always 84 87 84 76 84 90 Yes, sometimes 14 11 13 21 14 8 No, hardly ever 2 1 2 2 1 1 No never 1 1 1 1 1 < 1 Total 100 100 100 100 100 100 Q44: Are your belongings safe here? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,758) (N = 215) (N = 735) (N = 521) (N = 684) (N = 603) % % % % % % Yes, always 76 82 76 73 77 74 Yes, sometimes 18 11 16 24 18 19 No, hardly ever 4 4 5 2 3 6 No never 2 4 3 1 2 1 Total 100 100 100 100 100 100

APPENDIX VIII 169

Table 10: Dimension of Care: Resident Environment question-level results by AHS Zone

Q45: Do you think this is a pleasant place for people to visit? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,715) (N = 217) (N = 715) (N = 504) (N = 682) (N = 597) % % % % % % Yes, always 80 82 81 68 83 84 Yes, sometimes 17 17 14 29 15 14 No, hardly ever 2 < 1 3 2 2 1 No never 1 1 2 1 1 1 Total 100 100 100 100 100 100 Q46: Is the room temperature comfortable for you? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,806) (N = 217) (N = 743) (N = 526) (N = 708) (N = 612) % % % % % % Yes, always 61 57 64 52 63 63 Yes, sometimes 29 35 26 35 27 28 No, hardly ever 7 6 5 10 6 7 No never 3 2 4 4 3 2 Total 100 100 100 100 100 100

APPENDIX VIII 170

Table 11: Dimension of Care: General Satisfaction question-level results by AHS Zone

Q47: Do you feel comfortable here? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,782) (N = 218) (N = 730) (N = 520) (N = 706) (N = 608) % % % % % % Yes, always 77 78 78 68 77 82 Yes, sometimes 19 17 17 28 20 15 No, hardly ever 2 3 2 3 2 2 No never 1 1 2 1 1 1 Total 100 100 100 100 100 100 Q48: Do you feel like you are getting your money’s worth here? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,443) (N = 193) (N = 650) (N = 458) (N = 619) (N = 523) % % % % % % Yes, always 56 58 58 44 57 63 Yes, sometimes 30 25 27 38 32 24 No, hardly ever 9 11 8 11 7 9 No never 5 5 6 7 3 4 Total 100 100 100 100 100 100 Q49: Overall do you like living here? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,751) (N = 212) (N = 729) (N = 522) (N = 685) (N = 603) % % % % % % Yes, always 61 61 64 49 61 68 Yes, sometimes 30 28 27 41 30 25 No, hardly ever 5 4 5 6 5 5 No never 4 7 5 4 4 2 Total 100 100 100 100 100 100 Q50: Would you recommend this place to a family member or friend? Alberta North Zone Edmonton Zone Central Zone Calgary Zone South Zone (N = 2,637) (N = 207) (N = 701) (N = 496) (N = 649) (N = 584) % % % % % % Yes, always 70 71 74 59 70 74 Yes, sometimes 20 19 15 29 21 18 No, hardly ever 5 4 4 7 5 4 No never 5 5 7 5 4 4 Total 100 100 100 100 100 100

APPENDIX VIII 171

Table 12: Additional Care Questions question-level results by AHS Zone

Q52: Can you see a doctor if you need to? Edmonton Central Calgary Alberta North Zone South Zone Zone Zone Zone (N = 2,581) (N = 207) (N = 698) (N = 481) (N = 635) (N = 560) % % % % % % Yes, always 63 66 67 51 63 70 Yes, sometimes 28 20 25 38 30 24 No, hardly ever 7 9 6 9 6 4 No never 2 5 2 2 2 2 Total 100 100 100 100 100 100 Q53: Are you able to get transportation to or from medical appointments? Edmonton Central Calgary Alberta North Zone South Zone Zone Zone Zone (N = 2,297) (N = 180) (N = 638) (N = 413) (N = 524) (N = 542) % % % % % % Yes, always 68 71 69 54 70 76 Yes, sometimes 22 18 18 38 20 19 No, hardly ever 4 4 5 5 4 4 No never 5 7 8 3 6 1 Total 100 100 100 100 100 100 Q54: In the last 6 months, how often did you feel that there were enough nurses and aides at the facility? Edmonton Central Calgary Alberta North Zone South Zone Zone Zone Zone (N = 2,515) (N = 197) (N = 668) (N = 490) (N = 623) (N = 537) % % % % % % Always 43 37 45 33 51 43 Sometimes 22 26 21 26 19 21 Usually 28 29 25 33 25 29 Never 7 9 9 8 4 6 Total 100 100 100 100 100 100 Q55: Do the people who work here take a personal interest in your life? Edmonton Central Calgary Alberta North Zone South Zone Zone Zone Zone (N = 2,551) (N = 206) (N = 676) (N = 487) (N = 643) (N = 539) % % % % % % Yes, always 43 52 42 40 42 44 Yes, sometimes 40 33 39 43 42 41 No, hardly ever 11 10 11 10 12 12 No never 5 4 9 6 4 3 Total 100 100 100 100 100 100

APPENDIX VIII 172

Table 12: Additional Care Questions question-level results by AHS Zone (continued)

Q56: Do you get your mental health and emotional needs met? Edmonton Central Calgary Alberta North Zone South Zone Zone Zone Zone (N = 2,323) (N = 178) (N = 627) (N = 443) (N = 575) (N = 500) % % % % % % Yes, always 54 52 56 43 56 59 Yes, sometimes 33 38 28 45 33 28 No, hardly ever 8 7 9 7 8 9 No never 5 3 7 5 3 5 Total 100 100 100 100 100 100 Q57: Do you get your healthcare needs met? Edmonton Central Calgary Alberta North Zone South Zone Zone Zone Zone (N = 2,639) (N = 210) (N = 701) (N = 501) (N = 656) (N = 571) % % % % % % Yes, always 68 71 70 60 69 73 Yes, sometimes 26 23 23 36 27 23 No, hardly ever 3 3 5 2 3 4 No never 2 3 3 2 2 1 Total 100 100 100 100 100 100 Q58: Are you involved in making decisions about your care? Edmonton Central Calgary Alberta North Zone South Zone Zone Zone Zone (N = 2,565) (N = 198) (N = 698) (N = 466) (N = 637) (N = 566) % % % % % % Yes, always 52 51 57 40 56 53 Yes, sometimes 27 27 23 36 28 25 No, hardly ever 12 14 10 15 12 12 No never 8 8 11 10 4 10 Total 100 100 100 100 100 100 Q59: Does your facility have a Resident and Family Council? Edmonton Central Calgary Alberta North Zone South Zone Zone Zone Zone (N = 2,784) (N = 215) (N = 739) (N = 524) (N = 692) (N = 614) % % % % % % Yes 50 54 48 48 49 54 No 10 10 14 11 7 9 I don't know 40 36 38 40 45 37 Total 100 100 100 100 100 100

APPENDIX VIII 173

Table 12: Additional Care Questions question-level results by AHS Zone (continued)

Q60: In the last 6 months, have you been a part of a Resident and Family Council Meeting? Edmonton Central Calgary Alberta North Zone South Zone Zone Zone Zone (N = 2,415) (N = 178) (N = 672) (N = 427) (N = 605) (N = 533) % % % % % % Yes 34 44 28 36 35 35 No 66 56 72 64 65 65 Total 100 100 100 100 100 100 Q61: Do you feel that participating in the Resident and Family Council helped you feel heard about the things that matter to you? (Among those who answered Yes to Q60) Edmonton Central Calgary Alberta North Zone South Zone Zone Zone Zone (N = 761) (N = 70) (N = 180) (N = 146) (N = 193) (N = 172) % % % % % % Yes, always 50 61 53 36 50 52 Yes, sometimes 33 26 28 43 33 33 No, hardly ever 12 7 11 14 14 10 No never 6 6 8 6 4 5 Total 100 100 100 100 100 100

APPENDIX VIII 174

APPENDIX IX: MODELLING SPECIFICS

Model building steps A structural equation model was constructed to determine which Dimensions of Care most strongly influence overall resident experience (i.e., the Overall Care Rating). This analysis was conducted at the respondent-level with N = 2,857 respondents. Maximum likelihood estimation was used since there were some missing observations. Models were compared and adjusted on various fit indices to select the model that best fits the data. Select resident characteristics and survey questions were included in the analysis to explore how they change the relationships with overall resident experience. The selection of included variables was based on previous iterations of the survey as well as literature and consultation with stakeholders. Outcome measure Overall resident experience is made up of the Overall Care Rating which represents a respondent’s overall opinion about a site on a scale from 0 to 10, where 0 is the worst care possible and 10 is the best care possible. Selection of final model Similar to the factor analysis used to generate Dimension of Care summary scores, the questions in each Dimension of Care were first examined to ensure all questions loaded onto their associated conceptual theme or construct. Questions were excluded from the Dimension of Care construct if the factor loading was less than 0.3. These Dimension of Care constructs were analyzed in the final model with the overall experience outcome. Demographic covariates were also analyzed such as resident level of care. Covariates that were excluded were not significantly associated with the outcome, had small coefficients, or did not contribute to R-squared or other model fit indices relative to other similar and correlated covariates. For the final model, only age and gender were included. Mediation and Moderation effects were also explored. Overall, the included Dimensions of Care constructs and variables explained 32 per cent of the variance in overall experience.

APPENDIX IX 175

APPENDIX X: DETERMINING ACTIONS FOR IMPROVEMENT

In an effort to identify specific Actions for Improvement based on the survey results, the HQCA determined a method that prioritizes individual questions based on their potential for improvement of overall resident experience (i.e., the Overall Care Rating). Questions were prioritized based on the following two criteria:

. Strength of relationship to overall resident experience, and . The potential for, or room for, improvement. From this order, the top five survey questions were selected and were used to generate the Actions for Improvement. Determining question strength and prioritization criteria Four prioritization criteria were determined:

Table 1: Prioritization criteria

Criteria Measured by:

1. Strength of the Dimension of Care to Beta coefficient of Dimension of Care overall resident experience

2. Strength of Question to Dimension of Factor loading of question to Dimension of Care Care

3. Potential room for improvement (100 – [top-box score]) / 100

4. Question quality Discrimination criteria from IRT Analyses

The Dimensions of Care, as well as the Additional Care Questions that do not comprise any of the Dimensions of Care, were considered as components of the model. Six Dimensions of Care were found to significantly influence overall resident experience, as determined by statistical modelling (described in Appendix VII). Of these, the Dimension of Care Facility and Resident Environment had the strongest influence on overall resident experience as measured by the value of the beta coefficients. The strength of each of the Dimensions of Care was the first consideration in determining Actions for Improvement. In order to identify specific actions, the second consideration was the survey questions that make up each Dimension of Care. This involved 1) exploring the relationship of the question with the Dimension of Care, which is determined by their factor loading where the larger the value the stronger the relationship, and 2) exploring room for improvement in regards to the top-box or most positive score, whereby questions with lower scores have more opportunity for improvement. To determine the strength of the relationship of each question with overall resident experience, as part of a Dimension of Care, the Dimension of Care’s beta coefficient was multiplied by the factor loading for each question. The HQCA then took the proportion for improvement for each question by subtracting the top-box score from 100 then dividing by 100. These two numbers were then added to obtain a final prioritization score where larger numbers would get a higher priority.

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While not included in how the survey questions were ordered, the final consideration in selecting the top five questions was the quality of the question as indicated by the discrimination criteria from Item Response Theory analyses. Any questions with a discrimination of <1.35 were considered low- performing questions. Therefore, only questions that met the minimum discrimination criteria were ordered in decreasing final prioritization score. From this list, the top-five questions were selected to develop the Actions for Improvement.

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